305例Graves病患者^(131)I治疗后1年疗效及影响因素分析  

Analysis of Efficacy and Influencing Factors of Radioiodine Therapy in 305 Patients with Graves'Disease

作　　者：董佳佳[1] 章斌[1] 韩江琴[1] 朱婷婷[1] 杨翩 DONG Jia-jia;ZHANG Bin;HAN Jiang-qin;ZHU Ting-ting;YANG Pian(Department of Nuclear Medicine,the First Affiliated Hospital of Soochow University,Suzhou,Jiangsu,215006,China)

机构地区：[1]苏州大学附属第一医院核医学科,江苏苏州215006

出　　处：《中国血液流变学杂志》2021年第2期253-256,共4页Chinese Journal of Hemorheology

基　　金：江苏省青年医学重点人才项目(QNRC2016749),苏州市民生科技计划(SYS2019038)。

摘　　要：目的研究Graves病患者^(131)I治疗的影响因素,争取提高治愈率并降低持续甲减率。方法回顾性分析2018年1月—2019年5月305例临床确诊为Graves病患者,其中女性男性比例约为3:1,平均年龄(40.89±12.79)岁。收集每例患者资料,包括症状、体征、实验室检查、摄碘率、有效半衰期、^(131)I剂量及治疗后1年的甲亢缓解和甲减发生例数,并根据公式推算出实际^(131)I剂量率,分析甲亢预后的影响因素。用SPSS 19.0软件对数据行t检验。结果^(131)I治疗后1年甲亢缓解率43.93%(134/305);甲减发生率32.46%(99/305);合计有效率达76.39%(233/305)。单次治疗后复发率23.61%(72/305)。早发甲减率61.31%(187/305),持续性甲减率32.46%(99/305),甲状腺功能完全缓解及持续性甲减患者62.30%(190/305)为成功组,单次治疗后复发23.61%(72/305)为失败组。成功组与失败组之间TRAb(t=1.120,P=0.045)、^(131)I剂量(t=-1.874,P=0.022)、甲状腺实际^(131)I剂量率(t=2.659,P=0.027)差异有统计学意义,TRAb、^(131)I剂量、实际^(131)I剂量率为影响^(131)I治疗的有关因素。结论该方法^(131)I治疗Graves病后1年,甲亢治疗成功率较高,持续甲减发生率较低;TRAb、^(131)I剂量、实际^(131)I剂量率是影响^(131)I治疗成功的重要因素。Objective To study the influencing factors of^(131)I treatment for Graves'disease and to improve the cure rate and reduce the sustained hypothyroidism rate.Methods 305 cases of Graves'disease clinically diagnosed from January 2018 to May 2019 in the First Affiliated Hospital of Soochow University were retrospectively studied.The mean age was(40.89±12.79)y,with a female to male ratio of 3:1.Data including symptoms,signs,blood tests,radioactive iodine uptake(RAIU),effective half-life,radioiodine doses,remission rates and hypothyroidism incidences were collected.Early hypothyroidism was also recorded.SPSS 19.0 software was used to perform t-test on the data.Results One year after^(131)I treatment,the remission rate of hyperthyroidism was 43.93%(134/305),and the incidence of hypothyroidism was 32.46%(99/305),with a total effective rate of 76.39%(233/305).The recurrence rate after a single treatment was 23.61%(72/305).The rate of early onset hypothyroidism was 61.31%(187/305),and the rate of persistent hypothyroidism was 32.46%(99/305).62.30%(190/305)of the patients with complete remission of thyroid function and continuous hypothyroidism were the successful group,while 23.61%(72/305)of the patients with recurrence after a sing unsuccessful group.TRAb(t=1.120,P=0.045),^(131)I dose(t=-1.874,P=0.022),and the actual^(131)I dose rate of thyroid(t=2.659,P=0.027)were statistically significant differences between the successful group and the unsuccessful group.TRAb,^(131)I dose,and the actual^(131)I dose rate of thyroid were the related factors influencing^(131)I treatment.Conclusion One year after^(131)I treatment for Graves'disease,the success rate of hyperthyroidism treatment was relatively high,and the incidence of continuous hypothyroidism is lower.TRAb,^(131)I dose and actual^(131)I dose rate are important factors affecting the success of^(131)I treatment.

关 键 词：GRAVES病 ^(131)I 随访分析 

分 类 号：R581.1[医药卫生—内分泌] R817.8[医药卫生—内科学]