出 处:《中华核医学与分子影像杂志》2016年第6期525-528,共4页Chinese Journal of Nuclear Medicine and Molecular Imaging
摘 要:目的 优化格雷夫斯甲状腺功能亢进症(简称甲亢)患者131I有效半衰期估算方法。方法 通过测定126例格雷夫斯甲亢患者[男32例,女94例,年龄(38.47±11.49)岁]4、24、48、96、120、144、168、192和216 h甲状腺摄131I率(RAIU),实测131I在甲状腺内有效半衰期(EHL)。采用两独立样本均数t检验、双变量相关分析以及曲线拟合对RAIU高峰前移组和无高峰前移组相关数据进行统计学分析。结果 126例患者EHL为0.5~7.5(4.70±1.46) d。无高峰前移组(94例)的EHL为3.0~7.5(5.25±1.01) d,高峰前移组(32例)的EHL为0.5~6.0(3.24±1.52) d,差异有统计学意义(t=8.499,P〈0.01)。无高峰前移组131I转换率(RAIU4 h/RAIU24 h,%)与EHL不相关(r=-0.177,P〉0.05),高峰前移组RAIU4 h/RAIU24 h与EHL呈负相关(r=-0.724,P 〈0.01)。无高峰前移且RAIU24 h/RAIU48 h〉100%组的EHL为3.0~7.5(5.11±0.98) d,无高峰前移且RAIU24 h/RAIU48 h≤100%组EHL为4.0~7.0(5.91±0.94) d,差异有统计学意义(t=3.141,P〈0.01)。在高峰前移组中,自变量(RAIU4 h/RAIU24 h+RAIU24 h/RAIU48 h)估算EHL的S型曲线模型拟合优度最优(R2=0.930,F=397.22,均P〈0.01,b0=-3.038 0,b1=9.659 4)。结论 为了获得优化的EHL估算方法,应依据131I转换率分组估算。对于高峰前移的,采用(RAIU4 h/RAIU24 h+RAIU24 h/RAIU48 h)估算EHL;对于无高峰前移的,依据RAIU24 h/RAIU48 h〉100%和≤100%分组,采用各组EHL均数作为患者EHL预测值。Objective To explore optimized method of estimating 131I effective half-life(EHL) in patients with Graves′ disease(GD).Methods The EHL was obtained by measuring thyroid radioactive iodine uptake(RAIU) of 126 patients (32 males, 94 females, average age (38.47±11.49) years) with GD at 4, 24, 48, 96, 120, 144, 168, 192 and 216 h. Two-sample t test, bivariate correlation analysis and curve estimation were used for statistical analysis.Results The EHL of 126 patients was 0.5-7.5 (4.70±1.46) d. The EHL was 3.0-7.5(5.25±1.01) d and 0.5-6.0(3.24±1.52) d in group A (94 patients, without advanced peak of RAIU) and group B (32 patients, with advanced peak of RAIU), respectively, and the difference between the 2 groups was significant (t=8.499, P〈0.01). The EHL had no significant correlation with RAIU4 h/RAIU24 h (r=-0.177, P〉0.05) in group A, while it had negative correlation with RAIU4 h/RAIU24 h in group B (r=-0.724, P〈0.01). In group A, the EHL of patients with RAIU24 h/RAIU48 h〉100% was 3.0-7.5(5.11±0.98) d, the EHL of patients with RAIU24 h/RAIU48 h≤100% was 4.0-7.0(5.91±0.94) d (t=3.141, P〈0.01). In group B, when RAIU4 h/RAIU24 h+ RAIU24 h/RAIU48 h was used as the independent variable in S curve model to estimate the EHL, the result was the best (R2=0.930, F=397.22, both P〈0.01, b0=-3.038 0, b1=9.659 4).Conclusions In order to optimally estimate EHL, patients should be grouped according to 131I turnover. In patients with advanced peak of RAIU, the EHL should be calculated by using formula of (RAIU4 h/RAIU24 h+ RAIU24 h/RAIU48 h). If no advanced peak of RAIU exists, patients should be further divided according to RAIU24 h/RAIU48 h〉100% or RAIU24 h/RAIU48 h≤100%, and the EHL mean value of each group is taken as the estimated EHL.
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