^(131)I治疗后分化型甲状腺癌患者体内残留放射性活度变化趋势及相关影响因素研究  

Study on change trend and related influencing factors of residual radioactivity in patients with differentiated thyroid cancer after^(131)I treatment

作　　者：杨航 郑磊 厉红民 陈杰 潘牮臣 王郦彬 解天馨 黄定德 YANG Hang;ZHENG Lei;LI Hongmin;CHEN Jie;PAN Jianchen;WANG Libin;XIE Tianxin;HUANG Dingde(Department of Nuclear Medicine,First Affiliated Hospital of Army Medical University,Chongqing 400038,China)

机构地区：[1]中国人民解放军陆军军医大学第一附属医院核医学科,重庆400038

出　　处：《重庆医学》2025年第1期153-157,共5页Chongqing Medical Journal

摘　　要：目的探讨分化型甲状腺癌(DTC)患者接受^(131)I治疗后各时间点体内残留放射性活度变化情况及影响因素。方法选取2021年1月至2023年6月在该院接受^(131)I治疗的235例DTC患者为研究对象,根据治疗剂量分为高剂量组(>5.55 GBp,n=56)、低剂量组(≤5.55 GBp,n=179)。收集两组临床资料,对比^(131)I治疗后24、48、72 h体内残留放射性活度变化情况,采用二元logistic回归分析其影响因素。结果两组性别、年龄、BMI、基础代谢率(BMR)、血清甲状腺球蛋白抗体(TgAb)比较差异无统计学意义(P>0.05),低剂量组血清甲状腺球蛋白(Tg)<1 ng/mL比例、^(131)I首次治疗比例、T1比例、治疗后全身^(131)I扫描提示残余甲状腺比例均明显高于高剂量组(P<0.05)。两组体内残留放射性活度随时间延长均明显降低,低剂量组^(131)I治疗后24、48、72 h体内残留放射性活度均明显低于高剂量组(P<0.05)。二元logistic回归分析结果显示,T分期和^(131)I剂量是^(131)I治疗后DTC患者体内残留放射性活度的独立影响因素(P<0.05)。结论^(131)I治疗后DTC患者体内残留放射性活度随时间延长呈明显降低趋势,这一变化趋势对进一步优化完善隔离防护方案具有积极意义,对于T分期高、治疗剂量大的患者,隔离时间应超过72 h。Objective To investigate the changes of residual radioactivity at different time points after^(131)I treatment in the patients with differentiated thyroid cancer(DTC)and influencing factors.Methods A total of 235 patients with DTC receiving^(131)I treatment in this hospital from January 2021 to June 2023 were selected as the study subjects and divided into the high dose group(>5.55 GBp,n=56)and low dose group(≤5.55 GBp,n=179)according to the treatment dose.The clinical data of the two groups were collected and the changes of residual radioactivity after^(131)I treatment were compared between the two groups.The binary regression was used to analyze its influencing factors.Results The sex,age,BMI,basic metabolic rate(BMR)and serum thyroglobulin antibody(TgAb)had no statistical differences between the two groups(P>0.05).The proportions of serum thyroglobulin(TG)<1 ng/mL,^(131)I first time treatment and residual thyroid ratio prompted by the whole body^(131)I scan after treatment in the low dose group were significantly higher than those in the high dose group(P<0.05).The residual radioactivity in the two groups was significantly decreased with time extension.The residual radioactivity at 24,48,72 h after treatment in the low dose group was significantly lower than that in the high dose group(P<0.05).The binary logistic regression analysis results showed that the T stage and treatment dose were the influencing factors of residual radioactivity after^(131)I treatment.Conclusion The residual radioactivity after^(131)I treatment in the patients with DTC shows the significant decreasing trend with time extension,this change trend has an active significance for further optimizing and perfecting the isolation and protection scheme.For the patients with high T stage and big treatment dose,the isolation time should exceed 72 h.

关 键 词：分化型甲状腺癌 碘放射性同位素 放射疗法 影响因素 

分 类 号：R817.8[医药卫生—影像医学与核医学]