一次高剂量和多次小剂量131I治疗甲状腺功能亢进症的疗效对比分析  

Comparative analysis of the efficacy of once high dose and multiple low doses of 131 I in the treatment of hyperthyroidism

作　　者：苏俊 李会广 SU Jun;LI Huiguang(Department of Nuclear Medicine,Tongchuan Mining Bureau Central Hospital,Tongchuan,Shaanxi 727000,China)

机构地区：[1]陕西省铜川矿务局中心医院核医学科,陕西铜川727000

出　　处：《检验医学与临床》2020年第13期1857-1859,共3页Laboratory Medicine and Clinic

摘　　要：目的比较一次高剂量和多次小剂量131I治疗甲状腺功能亢进症(甲亢)的临床疗效。方法选取该院2016年5月至2019年5月收治的79例甲亢患者为研究对象,根据131I的治疗剂量分为高剂量组(39例,给予一次高剂量131I)与小剂量组(40例,多次小剂量131I),连续治疗6个月,比较两组临床疗效、甲状腺功能及早发性甲状腺功能减退发生率。结果高剂量组的总有效率(94.87%)与小剂量组的总有效率(95.00%)比较,差异无统计学意义(P>0.05)。治疗前,两组患者的促甲状腺激素(TSH)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、三碘甲状腺原氨酸(TT3)、总甲状腺素(TT4)水平差异无统计学意义(P>0.05)。与治疗前比较,治疗3个月时两组FT3、FT4、TT3和TT4水平均明显下降(P<0.05),TSH水平均明显上升(P<0.05);高剂量组的FT3、FT4、TT3和TT4水平均高于小剂量组(P<0.05),TSH水平低于小剂量组(P<0.05)。高剂量组早发性甲状腺功能减退发生率(38.46%)高于小剂量组(12.50%),差异有统计学意义(P<0.05)。结论两种剂量131I治疗甲亢均可取得显著疗效,但多次小剂量131I治疗甲亢后早发性甲状腺功能减退发生率较低,值得临床推广应用。Objective To compare the clinical efficacy of once high dose and multiple low doses of 131 I in the treatment of hyperthyroidism.Methods A total of 79 patients with hyperthyroidism admitted to our hospital from May 2016 to May 2019 were selected.According to the dose of 131 I,the patients were divided into high-dose group(39 cases,who were given once high dose of 131 I)and the low-dose group(40 cases,who were given multiple low doses of 131 I),continuous treatment was conducted for six months.The clinical efficacy,thyroid function and rates of early onset hypothyroidism were compared.Results There was no significant difference in the clinical efficacy between the high-dose group and the low-dose group(94.87%vs.95.00%,P>0.05).Before treatment,there were no significant differences in thyrotropin hormone(TSH),free triiodothyronine(FT 3),free thyroxine(FT 4),triiodothyronine(TT 3)and total thyroxine(TT 4)levels between the two groups(P>0.05).Three months after treatment,the levels of FT 3,FT 4,TT 3 and TT 4 decreased significantly in both groups(P<0.05),and TSH increased significantly(P<0.05).The levels of FT3,FT4,TT3 and TT4 in the high-dose group were significantly higher than that of the low-dose group(P<0.05),and the level of TSH was significantly lower than that of the low-dose group(P<0.05).The incidence of early onset hypothyroidism in the high-dose group(38.46%)was significantly higher than that of the low-dose group(12.50%),and difference was statistically significant(P<0.05).Conclusion Both once high dose and multiple small doses of 131 I could achieve significant curative effect on hyperthyroidism.However,the incidence of early onset hypothyroidism after treatment of hyperthyroidism after multiple low doses of 131 I treatment is lower,which is worthy of clinical application.

关 键 词：131I 甲状腺功能 临床疗效 

分 类 号：R815[医药卫生—放射医学]