低剂量^(131)I治疗Graves’甲亢疗效及影响因素的分析  

Analysis of the influencing factors and the therapeutic effect in low-dose iodine-131 therapy for Graves' hyperthyroidism

作　　者：杨永东[1] 张文生[1] 黄炜坤[1] 

机构地区：[1]福建医科大学附属龙岩第一医院核医学科,福建龙岩364000

出　　处：《中国现代医生》2016年第1期85-87,共3页China Modern Doctor

摘　　要：目的分析低剂量^(131)I(一次性给药剂量<185 MBq)治疗Graves’甲亢的疗效及影响因素。方法 2011年1月~2012年12月间对341例Graves’甲亢患者采用计算活度法、行低剂量^(131)I治疗后1年,以治愈、好转、甲减3个结局为因变量,以性别、年龄、病程、TGAb、TPOAb、TRAb、甲状腺24 h摄碘率、甲状腺^(131)I有效半衰期、甲状腺重量、每克甲状腺用药量、治疗剂量为自变量。结果 341例患者中,治愈110例(78.6%),甲减158例(46.3%),好转69例(20.2%)。剔除无显著性意义的自变量后,对疗效有明显影响因素的有TPOAb(OR=1.001)、甲状腺重量(OR=0.918)、治疗剂量(OR=2.194)、甲状腺^(131)I有效半衰期(OR=1.169)。结论低剂量的^(131)I治疗Graves’甲亢效果显著。治疗Graves’甲亢应用^(131)I前应该综合考虑各种影响因素,尽可能达到满意的疗效。Objective To study the influencing factors and therapeutic effect in the low dose^131I（a one-time dose 185MBq） treatment of Graves disease. Methods From Jan. 2011 to Dec. 2012, 341 patients with Graves disease were treated with low dosage of ^131I for one-year term. Polytomous logistic regression model and Maximum likelihood estimation of fitting model were used to study the 341 cases mentioned above, according to the date of cure, improvement and hypothyroidism as the dependent variables and the date of gender, age, the course of disease, TGAb, TPOAb, TRAb,the 24-hour thyroid Iodine uptake rate, the thyroid Iodine effective half-life, the weight of thyroid and the dosage of treatment as the independent variables. Results Of all 341 cases, 110 cases（32.3%） had been cured, 158 cases（46.3%）had transformed into hypothyriodism, 69 cases（20.2%） had improved. When the no significance independent variables had been eliminated, the therapeutic effect was closely related to these factors, TPOAb（OR=1.001）, the weight of thyroid（OR=0.918）, the dosage of treatment（OR=2.194） and the thyroid Iodine-131 effective half-life（OR=1.169）. Conclusion The low-dose ^131I in treatment of Graves＇ hyperthyroidism is remarkably effective. All kinds of influencing factors should be considered comprehensively before^131I is used to treat Graves＇ hyperthyroidism, to achieve satisfactory effect as much as possible.

关 键 词：^131I Graves’甲亢 低剂量 多因素分析 

分 类 号：R581.1[医药卫生—内分泌]