[1]王越,晋建华,李思进,等.甲状腺24h摄碘率与131I治疗Graves甲亢疗效相关性研究[J].国际放射医学核医学杂志,2015,39(6):442-446.[doi:10.3760/cma.j.issn.1673-4114.2015.06.002]
　Wang Yue,Jin Jianhua,Li Sijin,et al.Correlation between thyroid 24 h of radioactive iodine uptake and clinical efficacy of 131I therapy for Graves’ hyperthyroidism[J].International Journal of Radiation Medicine and Nuclear Medicine,2015,39(6):442-446.[doi:10.3760/cma.j.issn.1673-4114.2015.06.002]
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《国际放射医学核医学杂志》[ISSN:1673-4114/CN:12-1381/R]

卷:
39
期数:
2015年第6期
页码:
442-446
栏目:
出版日期:
2015-11-25

文章信息/Info

Title:
Correlation between thyroid 24 h of radioactive iodine uptake and clinical efficacy of 131I therapy for Graves’ hyperthyroidism
作者:
王越;  晋建华;  李思进;  刘建中;  武志芳;  陆克义;  李江萍
030001 太原, 山西医科大学第一医院核医学科
Author(s):
Wang Yue;  Jin Jianhua;  Li Sijin;  Liu Jianzhong;  Wu Zhifang;  Lu Keyi;  Li Jiangping
Department of Nuclear Medicine, the First Hospital of Shanxi Medical University, Taiyuan 030001, China
关键词:
格雷夫斯病; 碘放射性同位素; 甲状腺功能亢进症; 治疗结果
Keywords:
Graves disease; Iodine radioisotopes; Hyperthyroidism; Treatment outcome
DOI:
10.3760/cma.j.issn.1673-4114.2015.06.002
摘要:
目的 对甲状腺 24 h 摄碘率 (24 h RAIU) 与 131I 治疗 Graves 甲状腺功能亢进症 (甲亢) 的临床疗效进行相关性分析。方法 对 3218 例首次使用放射性 131I 治疗的 Graves 甲亢患者进行集中随访,随访时间为 6~60 个月。成功随访 2690 例。患者实际服 131I 剂量为 74~1850 MBq.依据 131I 治疗前甲状腺 24 h RAIU,将患者分为 A 组 (24 h RAIU<50.0%) 405例、B 组 (50.0%≤24 h RAIU≤80.0%) 1764 例、C 组 (24 h RAIU >80.0%) 521 例。依据治疗效果将本次成功随访患者分为治愈组 (包括痊愈及甲状腺功能减退)、未愈组 (包括好转、无效及复发).结果 131I 治疗的 2690 例患 者中, 治愈 2244 例 (83.4%),未愈 446 例 (16.6%).其中,A 组治愈 360 例(88.9%)、未愈 45例 (11.1%);B 组治愈 1534 例 (87.0%)、未愈 230 例 (13.0%);C 组治愈 350例 (67.2%)、未愈171 例 (32.8%);A、B、C 3 组 Graves 甲亢患者间治愈率及未愈率比较,差异均有统计学意义 (x2=21.80,P<0.05).多元线性回归分析发现,甲状腺 24 h RAIU 与患者年龄(b=-0.259)、甲状腺质量 (b=0.340)、患者性别 (b=0.275)、是否使用抗甲状腺药物 (ATD) 治疗(b=-0.226) 等均有线性回归关系。 结论 甲状腺 24 h RAIU 与 131I 治疗 Graves 甲亢患者的临床疗效相关。24 h RAIU 越低治愈率越高,24 h RAIU 越高未愈率越高。甲状腺质量越大、年龄越小、女性、无 ATD 治疗史者甲状腺 24 h RAIU 越高；甲状腺质量越小、年龄越大、男性、有 ATD 治疗史者甲状腺 24 h RAIU 越低。该研究结果将为临床 131I 治疗 Graves 甲亢提供参考。
Abstract:
Objective To evaluate the correlation between 24 h of radioactive iodine uptake(24 h RAIU) and clinical efficacy of 131I therapy for Graves’ hyperthyroidism. Methods Data of 3218 patients with Graves’ hyperthyroidism from August 2009 to July 2014 were collected after a follow-up study. The follow-up times were 6 months to 60 months(mean: 28.36±14.06 months). All patients underwent radioactive 131I therapy for the first time in the first hospital of Shanxi medical university. A total of 2690 patients(83.6% of 3218 patients) were followed up. These patients comprised 855 males and 1835 females, with ages ranging from 11 years to 81 years(average: 42.81 ± 15.06 years). Patients were treated with 131I therapy doses of 74 MBq to 1850 MBq (mean dose: 402.50±279.94 MBq) and divided into three groups based on thyroid 24 h RAIU before 131I therapy as follows: group A, 405 cases(24 h RAIU<50.0%); group B, 1764 cases(50.0%≤24 h RAIU≤80.0%); and group C, 521 cases(24 h RAIU > 80.0%). Additionally, the patients were divided into two groups based on the follow-up results of patients treated with 131I therapy. The cured group consisted of cases that were healed or had presented hypothyroidism, whereas the uncured group comprised cases with improved, invalid, and recurrent conditions. Results A total of 2690 patients with Graves’ hyperthyroidism were treated with radioactive 131I, of which 2244 cases were cured(83.4%), and 446 cases were uncured(16.6%). In group A, 360 cases(88.9%) were cured, and 45 cases(11.1%) were uncured. In group B, 1534 cases(87.0%) were cured, and 230 cases(13.0%) were uncured. In group C, 350 cases(67.2%) were cured, and 171 cases(32.8%) were uncured. Statistically significant differences were found between the cured and uncured rates among the three groups(x2=21.80, P<0.05). Multivariate linear regression results indicated that age(b=0.259), thyroid weight(b=0.340), gender(b=0.275), and use of anti-thyroid drugs(ATD) treatment(b=0.226) were all correlated with thyroid 24 h RAIU. Conclusion Thyroid 24 h RAIU was related to the clinical efficacy of 131I therapy for Graves’ hyperthyroidism. Low 24 h RAIU implies high cure rate, whereas high 24 h RAIU indicates high failure rate. High 24 h RAIU was primarily caused by high thyroid weight, young age, female gender, and lack of ATD treatment. By contrast, low thyroid weight, old age, male gender, and history of ATD treatment can lead to low 24 h RAIU. Overall, this study will provide further information regarding clinical 131I treatment of Graves’ hyperthyroidism.

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备注/Memo

备注/Memo:
收稿日期:2015-3-13。
通讯作者:晋建华,Email:jjh1225@126.com
更新日期/Last Update: 1900-01-01