公式法碘-131治疗Graves病甲亢甲状腺吸收剂量误差分析  

Error analysis of the absorbed dose of thyroid in patients with Graves' disease accompanied with hyperthyroidism treated by iodine-131 with formula method

作　　者：何芳[1] 王月慧 黄金城[2] 谢思培 陈仰纯[2] HE Fang WANG Yuehui HUANG Jincheng XIE Sipei CHEN Yangchun(Department of Endocrine, Quanzhou First Hospital of Fujian Medical University, Quanzhou 362000, China Department of Nuclear Medicine, Quanzhou First Hospital of Fujian Medical University, Quanzhou 362000, China Department of Ultrasound, Quanzhou First Hospital of Fujian Medical University, Quanzhou 362000, China)

机构地区：[1]福建医科大学附属泉州第一医院内分泌科,福建泉州362000 [2]福建医科大学附属泉州第一医院核医学科,福建泉州362000 [3]福建医科大学附属泉州第一医院超声科,福建泉州362000

出　　处：《中国医学物理学杂志》2017年第9期879-881,共3页Chinese Journal of Medical Physics

基　　金：福建省自然科学基金(2016J01611)

摘　　要：目的:探讨公式法碘-131治疗Graves病甲状腺机能亢进症(甲亢)致甲状腺吸收剂量的误差。方法:对28例Graves病甲亢患者,采用超声计算甲状腺质量,并计算多时点测量甲状腺摄碘率(RAIU)、碘-131在甲状腺内有效半衰期(T_(1/2eff))、滞留时间(RT)。设碘-131计划量为3.7 MBq/g,根据RAIU_(24h)校正计算碘-131给药活度,依据RT计算该活度致甲状腺吸收剂量。采用t检验分析结果。结果:甲状腺质量为(34.0±21.4)g,RAIU_(24h)为(0.505±0.122),T_(1/2eff)为(3.56±0.92)d,RT为(2.98±1.03)d,公式法计算碘-131活度致甲状腺吸收剂量为(61.4±17.0)Gy,明显低于处方剂量75 Gy(t=-4.15,P<0.01)。结论:临床上常用的计算碘-131活度方法致甲状腺吸收剂量明显低于处方剂量,误差较大,这主要与T_(1/2eff)较小且变异系数大有关。Objective To evaluate the error of the absorbed dose of thyroid in the treatment of iodine-131 with formula method for Graves＇ disease complicated with hyperthyroidism. Methods Twenty-eight patients with Graves＇ disease accompanied with hyperthyroidism were included in this study. The thyroid mass was measured by ultrasound, and the radioiodine uptake（RAIU）at different time-points, effective half-time of iodine-131 in thyroid（T1/2eff） and resident time（RT） were computed. According to the formula method, a prescribed activity of iodine-131 was 3.7 MBq/g that was corrected by RAIU24h. The absorbed dose of thyroid was calculated based on RT. The results were analyzed with t-test. Results The thyroid mass, RAIU24h, T1/2eff, and RT was（34.0±21.4） g,（0.505±0.122）,（3.56±0.92） d,（2.98±1.03） d, respectively. Based on the activity of iodine-131 calculated by formula method, the absorbed dose of thyroid was（61.4±17.0） Gy, significantly lower than prescribed dose（75 Gy）（t=-4.15, P〈0.01）.Conclusion With the activity of iodine-131 determined by the clinical formula method, the absorbed dose of thyroid was significantly lower than the prescribed dose because of the small T1/2eff and large variable coefficient.

关 键 词：GRAVES病 甲状腺机能亢进症 甲状腺摄碘率 有效半衰期 吸收剂量 

分 类 号：R453[医药卫生—治疗学] R446[医药卫生—临床医学]