影响碳酸锂延长甲亢患者^(131)I有效半衰期的临床因素研究  

Clinical factors affecting lithium carbonate in prolonging the effective half-life of ^(131)I in patients with hyperthyroidism

作　　者：吴彬彬 王瑞华[1] 闫志华[1] 周倩 韩星敏[1] 刘保平[1] Wu Binbin;Wang Ruihua;Yan Zhihua;Zhou Qian;Han Xingmin;Liu Baoping(Department of Nuclear Medicine,the First Affiliated Hospital of Zhengzhou University,Henan Provincial Key Medical Laboratory of Molecular Imaging,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院核医学科、河南省分子影像医学重点实验室,450052

出　　处：《中华核医学与分子影像杂志》2021年第5期286-290,共5页Chinese Journal of Nuclear Medicine and Molecular Imaging

摘　　要：目的筛选有利于延长^(131)I有效半衰期的因素,为碳酸锂辅助放射性^(131)I治疗甲状腺功能亢进症(简称甲亢)选择更合适的患者提供依据。方法该前瞻性研究收集2017年7月至2019年3月间在郑州大学第一附属医院行^(131)I治疗前进行碳酸锂辅助治疗的61例患者[男23例,女38例,年龄13~73(37.7±1.9)岁]。采用配对t检验比较患者服用碳酸锂前后各临床参数[血清游离三碘甲状腺原氨酸(FT_(3)),血清游离甲状腺素(FT_(4)),2 h、4 h和24 h摄碘率,2 h/24 h和4 h/24 h摄碘率比值]的变化,采用简单线性回归和多重线性回归分析有利于延长^(131)I有效半衰期的因素。结果与治疗前相比,碳酸锂治疗后可显著提高24 h摄碘率[(74.82±2.69)%和(82.38±2.33)%;t=2.674,P=0.010]、降低4 h/24 h摄碘率比值[(88.96±2.85)%和(82.12±2.27)%;t=2.644,P=0.010]、延长^(131)I有效半衰期[(123.03±3.09)和(130.38±2.49)h;t=2.656,P=0.010]及降低FT_(3)[(26.46±1.65)和(21.31±1.42)pmol/L;t=3.421,P=0.001]和FT_(4)[(56.59±2.12)和(49.24±2.19)pmol/L;t=3.289,P=0.002]。简单线性回归分析显示,2 h和4 h摄碘率、2 h/24 h和4 h/24 h摄碘率比值及治疗前^(131)I有效半衰期与治疗后^(131)I有效半衰期相关(b值:-0.576~0.642,均P<0.05);多重线性回归分析显示,4 h/24 h摄碘率比值是影响碳酸锂治疗后^(131)I有效半衰期变化的主要因素(b=0.642,95%CI:0.453~0.832,P<0.001)。多重线性回归方程为y=-49.785+0.642x,4 h/24 h摄碘率比值超过77.55%时服用碳酸锂治疗后可延长^(131)I有效半衰期。结论4 h/24 h摄碘率比值是影响碳酸锂治疗后^(131)I有效半衰期变化的主要因素,且4 h/24 h摄碘率比值超过77.55%的甲亢患者服用碳酸锂治疗后可延长^(131)I有效半衰期。Objective To screen the factors that were conducive to prolonging the effective half-life of ^(131)I,and to provide a basis for selecting more suitable patients for the treatment of hyperthyroidism with lithium carbonate assisted radioactive ^(131)I.Methods Between July 2017 and March 2019,a total of 61 patients(23 males,38 females,age:13-73(37.7±1.9)years)who received lithium carbonate adjuvant therapy before ^(131)I treatment in the First Affiliated Hospital of Zhengzhou University were collected into this prospective study.Clinical parameters(serum free triiodothyronine(FT_(3)),serum free thyroxine(FT_(4)),iodine uptake rate(2 h,12 h,24 h)and ratio of iodine uptake rate(2 h/24 h,4 h/24 h)before and after taking lithium carbonate were compared by using paired t test.The factors which were conducive to prolonging the effective half-life of ^(131)I were analyzed by linear and multiple regression analyses.Results Compared with the pretreatment results,lithium carbonate treatment significantly improved the 24 h iodine uptake rate((74.82±2.69)%vs(82.38±2.33)%;t=2.674,P=0.010),decreased the ratio of 4 h/24 h iodine uptake rate((88.96±2.85)%vs(82.12±2.27)%;t=2.644,P=0.010),prolonged the effective half-life of ^(131)I((123.03±3.09)vs(130.38±2.49)h;t=2.656,P=0.010),and decreased serum FT_(3)((26.46±1.65)vs(21.31±1.42)pmol/L;t=3.421,P=0.001)and serum FT_(4)((56.59±2.12)vs(49.24±2.19)pmol/L;t=3.289,P=0.002).Linear regression analysis showed that 2 h and 4 h iodine uptake rate,the ratios of 2 h/24 h and 4 h/24 h iodine uptake rate,and effective half-life of ^(131)I before lithium carbonate treatment were related to the effective half-life of ^(131)I after lithium carbonate treatment(b values:from-0.576 to 0.642,all P<0.05).Multiple linear regression analysis showed that the ratio of 4 h/24 h iodine uptake rate was the main factor affecting the effective half-life of ^(131)I after taking lithium carbonate(b=0.642,95%CI:0.453-0.832,P<0.001).Multiple linear regression equation was y=-49.785+0.642x.Lithium carbonate

关 键 词：甲状腺功能亢进症 放射疗法 碘放射性同位素 半衰期 碳酸锂 

分 类 号：R581.1[医药卫生—内分泌]