上海交通大学学报(医学版)

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计算剂量方案行格雷夫斯病甲状腺功能亢进放射性碘治疗的疗效分析

傅宏亮1,杜学亮1,李佳宁1,马 超1,吴震宇1,吴书其1,叶智轶1,冯 方1,陈素芸1,王 辉1,蒋宁一2   

  1. 1.上海交通大学 医学院附属新华医院核医学科, 上海 200092; 2.中山大学 孙逸仙纪念医院核医学科, 广州 510000
  • 出版日期:2014-07-28 发布日期:2014-08-11
  • 通讯作者: 王 辉, 电子信箱: wanghuishanghai@hotmail.com; 蒋宁一, 电子信箱: ningyij@163.net。
  • 作者简介:傅宏亮(1969—), 男, 副主任医师, 硕士; 电子信箱: fuhongliang@hotmail.com。
  • 基金资助:

    公益性行业科研专项课题(200802028)

Analysis of therapeutic effect of empirically calculated dose of radioiodine therapy on hyperthyroidism of Graves disease

FU Hong-liang1, DU Xue-liang1, LI Jia-ning1, MA Chao1, WU Zhen-yu1, WU Shu-qi1, YE Zhi-yi1, FENG Fang1, CHEN Su-yun1, WANG Hui1, JIANG Ning-yi2   

  1. 1.Department of Nuclear Medicine, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China; 2.Department of Nuclear Medicine,Guangzhou Sun Yat-sun Memorial Hospital, Sun Yat-sun University, Guangzhou 510000, China
  • Online:2014-07-28 Published:2014-08-11
  • Supported by:

    Foundation of Public Welfare Industry, 200802028

摘要:

目的 分析计算剂量方案行格雷夫斯病甲状腺功能亢进(Graves甲亢)放射性碘(131I)治疗的效果。方法 299例Graves甲亢患者行131I治疗,根据计算剂量法方案确定131I治疗剂量,分别于131I治疗后3、6个月行甲状腺功能检测以评估疗效,多因素回归分析131I治疗效果的影响因素。结果 299例Graves甲亢患者,131I治疗后3个月治疗有效187例(62.5%),其中甲状腺功能减退(甲减)84例(28.1%);131I治疗后6个月治疗有效248例(83.0%),其中甲减107例(35.8%)。多因素回归分析显示,甲状腺质量、甲状腺最高摄碘率和血清游离三碘甲状腺原氨酸(FT3)水平是Graves甲亢131I治疗效果的主要影响因素(均P<0.05)。结论 计算剂量方案行Graves 甲亢131I治疗,应充分考虑甲状腺质量、最高摄碘率和血清FT3水平对疗效的影响;计算剂量方案131I治疗较适合于抗甲状腺药物疗效差、复发或有严重不良反应的Graves甲亢患者。

关键词: 格雷夫斯病, 甲状腺功能亢进, 放射性碘治疗, 计算剂量方案

Abstract:

Objective To analyze the effects of empirically calculated dose of radioiodine (131I) therapy on hyperthyroidism of Graves disease. Methods A total of 299 patients with Graves disease underwent the 131I therapy. The dose of 131I therapy was determined based on the empirically calculated dose. The therapeutic effect was
evaluated by the thyroid function test after 3 and 6 months of the treatment. Stepwise multiple regression analysis was performed to identify factors that influenced the effect of the 131I therapy. Results Among 299 cases of Graves disease, the 131I therapy was effective for 187 (62.5%) cases after being treated for 3 months and the incidence of hypothyroidism caused by the treatment was 84 (28.1%) cases. The 131I therapy was effective for 248 (83.0%) cases after being treated for 6 months and the incidence of hypothyroidism caused by the treatment was 107 (35.8%) cases. The multiple regression analysis showed that the weight of thyroid, the maximum radioiodine uptake of thyroid, and the free triiodothyronine (FT3) level were major factors that influenced the effect of the 131I therapy (P<0.05). Conclusion The empirically calculated dose of 131I therapy for the treatment of Graves disease should take into account the effects of weight of thyroid, the maximum radioiodine uptake of thyroid, and the FT3 level on the therapy. The empirically calculated dose of 131I therapy is suitable for recurrent patients or patients with poor therapeutic effect for anti-thyroid drug or severe side effects.

Key words: Graves disease, hyperthyroidism, radioiodine (131I) therapy, empirically calculated dose