核素动态显像对^(131)Ⅰ治疗分化型甲状腺癌患者唾液腺损伤程度的评价  

Evaluation of Degree of Salivary Gland Injury in Differentiated Thyroid Carcinoma Patients Treated with 131 Iodine by Dynamic Radionuclide Imaging

作　　者：周科 贾志云 ZHOU Ke;JIA zhiyun(Department of Nuclear Medicine, Huaxi Hospital, Chengdu 610041, China)

机构地区：[1]华西医院核医学科,成都610041

出　　处：《解放军预防医学杂志》2019年第1期83-85,99,共4页Journal of Preventive Medicine of Chinese People's Liberation Army

基　　金：国家自然科学基金资助项目(No.81260153)

摘　　要：目的探讨核素动态显像对^(131)Ⅰ治疗分化型甲状腺癌患者唾液腺损伤程度的评价研究。方法选取2017年9月-2018年9月入我院进行^(131)Ⅰ放射性治疗的分化型甲状腺癌患者46例,依据病理程度分为对照组与研究组。对照组23例,均清除残余甲状腺,应用低剂量^(131)Ⅰ治疗;研究组23例,均清除残余甲状腺并治疗转移病灶,进行高剂量^(131)Ⅰ治疗。患者唾液腺损伤程度应用核素动态显像进行测定。对比两组患者唾液腺-腮腺99T_C^mO_4^-显像结果唾液腺-颌下腺99T_C^mO_4^-显像结果以及^(131)Ⅰ治疗前后唾液腺功能指标状况。结果两组患者^(131)Ⅰ治疗前唾液腺-腮腺、唾液腺-颌下腺的最大浓聚率(MAR)和酸刺激后最大分泌率(MSR)差异均不显著(P>0.05),治疗1个月后MAR与MSR比治疗前均出现显著下降,治疗3个月后均有所恢复,且研究组恢复效果显较对照组差(P<0.05);两组患者治疗前唾液腺功能排泌率(ER)、排泌时间(EP)、排泌分数(EF)、UR20指标差异不显著(P>0.05),治疗后研究组ER、EF、UR20均比对照组降低,EP比对照组延长(P<0.05)。结论应用^(131)Ⅰ首次治疗分化型甲状腺癌患者,会在短时间内损伤患者的唾液腺功能,且唾液腺的受损程度跟^(131)Ⅰ的应用剂量存在相关性,用药剂量越大,对唾液腺的损伤程度越大。Objective To evaluate the degree of salivary gland injury in differentiated thyroid carcinoma patients treated with^131Iodine by dynamic radionuclide imaging.Methods Forty-six patients with differentiated thyroid carcinoma who were admitted to our hospital for^131I radiotherapy between September 2017 and September 2018 were selected and included in this study.They were divided into the control group and study group according to the pathological degree.The control group included 23 patients,all of whom were cleared of the residual thyroid gland and treated with low dose^131Iodine.All the 23 patients in the study group were treated with high dose^131Iodine to remove the residual thyroid gland and treat metastatic lesions.The degree of salivary gland injury in both groups was determined by dynamic radionuclide imaging.The results of^99TC^mO4^-imaging of the salivary gland and parotid gland,^99TC^mO4^-imaging of the salivary gland and submandibular gland,and the status of salivary gland function indexes before and after^131I treatment in the two groups were compared.Results The maximum concentration rate(MAR)of the salivary gland-parotid gland、salivary gland-submandibular gland,and the maximum secretion rate(MSR)of acid stimulation before^131I treatment were not comparable between the two groups(P>0.05).MAR and MSR were significantly decreased after one month of treatment,and recovered after three months of treatment.The recovery of the study group was significantly better than that of the control group(P<0.05).Before treatment,there were no comparable differences in the salivary gland function secretion rate(ER),secretion time(EP),secretion fraction(EF)or UR20 indexes between the two groups(P>0.05).After treatment,ER and EPUR20 in the study group were lower than those in the control group and EF was prolonged(P<0.05).Conclusion The application of^131I in the first treatment of thyroid cancer patients will damage the salivary gland function in a short time,and the degree of salivary gland damage is correlated with

关 键 词：甲状腺癌 131I治疗 核素动态显像 唾液腺损伤 评价 

分 类 号：R736.1[医药卫生—肿瘤]