[1]田琦,蒋宁一,郑丽.265例精细个体化131I治疗Graves甲亢的疗效观察[J].国际放射医学核医学杂志,2016,40(4):259-262.[doi:10.3760/cma.j.issn.1673-4114.2016.04.004]
 Tian Qi,Jiang Ningyi,Zheng Li.Therapeutic effect of fine individual 131I treatment on Graves disease hyperthyroidism[J].International Journal of Radiation Medicine and Nuclear Medicine,2016,40(4):259-262.[doi:10.3760/cma.j.issn.1673-4114.2016.04.004]
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265例精细个体化131I治疗Graves甲亢的疗效观察(/HTML)
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《国际放射医学核医学杂志》[ISSN:1673-4114/CN:12-1381/R]

卷:
40
期数:
2016年第4期
页码:
259-262
栏目:
出版日期:
2016-07-25

文章信息/Info

Title:
Therapeutic effect of fine individual 131I treatment on Graves disease hyperthyroidism
作者:
田琦 蒋宁一 郑丽
510000 广州, 中山大学孙逸仙纪念医院核医学科
Author(s):
Tian Qi Jiang Ningyi Zheng Li
Department of Nuclear Medicine, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou 510000, China
关键词:
格雷夫斯病甲状腺功能亢进症碘放射性同位素放射疗法精细个体化治疗
Keywords:
Graves diseaseHyperthyroidismIodine radioisotopesRadiotherapyIndividualized treatment
DOI:
10.3760/cma.j.issn.1673-4114.2016.04.004
摘要:
目的 观察 265例Graves甲亢患者精细个体化131I 治疗后的疗效。方法 回顾性分析265例应用 131I治疗的Graves甲亢患者的临床资料,引入精细个体化治疗方案矫正系数,根据甲状腺大小、最高吸碘率、是否为毒性结节性或毒性弥漫性甲状腺肿等指标对矫正系数进行精细化,进而调整服131I的剂量,跟踪随访至少6个月。结果 服药后 3个月、6个月患者临床症状显着改善,TSH、血清游离三碘甲腺原氨酸、血清游离甲状腺素较治疗前明显降低,131I治疗后3个月和6个月的有效率分别为63.4%和81.5%,甲减率分别为24.9%和27.9%.结论 精细个体化131I治疗Graves甲亢能够明显改善患者的临床症状,具有比较可靠的治疗效果。
Abstract:
Objective To evaluate the effect of fine individual 131I treatment on patients with Graves disease hyperthyroidism. Methods Retrospective analysis was carried out to evaluate the effect of fine individual 131I treatment on 265 cases of Graves disease hyperthyroidism. On the basis of thyroid size, the thyroid’s maximum radioiodine uptake, and the toxic nodular, the individual treatment correction coefficient was introduced to appropriately adjust the 131I dose. The therapeutic effect was evaluated through thyroid function tests 3 and 6 months post-treatment. Results The clinical symptoms in the 265 patients with Graves disease hyperthyroidism significantly improved after the fine individual 131I treatment in 3 and 6 months. Out of the 265 Graves disease cases, the 131I therapy was effective for 168(63.4%) cases after 3 months of treatment, and the hypothyroidism incidence rate caused by the treatment was 66 (24.9%). The 131I therapy was effective for 216(81.5%) cases after 6 months of treatment, and the hypothyroidism incidence rate caused by the treatment was 74(27.9%). Conclusion The fine individual 131I treatment of Graves disease hyperthyroidism indicated a good curative effect, which is noteworthy and promising in clinical treatment.

参考文献/References:

[1] 中华医学会内分泌学分会《中国甲状腺疾病诊治指南》编写组.中国甲状腺疾病诊治指南——甲状腺功能亢进症[J].中华内科杂志, 2007, 46(10): 876-882.DOI:10.3760/j.issn:0578-1426.2007.10.035 Drafting Group of the Chinese Medical Association Endocrinology Branch China.China thyroid disease treatment guidelines—hyperthyroidism[J].Chin J Intern Med, 2007, 46(10): 876-882.
[2] 中华医学会核医学分会.131I治疗格雷夫斯甲亢指南(2013版)[J].标记免疫分析与临床, 2014, 21(1):92-104.DOI:10. 11748/bjmy. issn. 1006-1703. 2014. 01. 030.Chinese Society of Nuclear Medicine.131I treatment of Graves’ hyperthyroidism Guide(2013 Edition)[J].Labeled Immunoassays & Clin Med, 2014, 21(1): 92-104.
[3] 万芳, 林秋玉, 赵红光, 等.131I治疗甲状腺功能亢进症的研究进展[J].吉林大学学报:医学版, 2013, 39(4): 851-854.DOI:10.7694/jldxyxb20130444.Wan F, Lin QY, Zhao HG, et al.Advanced research on 131I in treatment of hyperthyroidism[J].J Jilin Univ(Med Edit), 2013, 39(4): 851-854.
[4] 蒋宁一, 匡安仁, 谭建, 等.131I治疗Graves甲亢专家共识(2010年)[J].中华核医学杂志, 2010, 30(5): 346-351.DOI:10.3760/cma.j.issn.0253-9780.2010.05.019.Jiang NY, Kuang AR, Tan J, et al.131I therapy for Graves hyperthyroidism expert consensus(2010)[J].Chin J Nucl Med, 2010, 30(5): 346-351.
[5] 徐志勇, 周嘉强.131I治疗甲状腺疾病进展[J].全科医学临床与教育, 2012, 10(2): 170-172.DOI:10.3969/j.issn.1672-3686.2012.02.016.Xu ZY, Zhou JQ.131I thyroid disease progression treatment[J].Clin Edu Gen Prac, 2012, 10(2): 170-172.
[6] 张永学, 黄钢.核医学[M].2版.北京:人民卫生出版社, 2010: 209-233.Zhang YX, Huang G.Nuclear Medicine[M].2nd ed.Beijing:People’s Medical Publishing House, 2010: 209-233.
[7] 武海明, 谭天秩, 匡安仁, 等.131I治疗Graves甲亢疗效影响因素的研究[J].中华核医学杂志, 2003, 23(5): 291, 293.DOI:10.3760/cma.j.issn.2095-2848.2003.05.024.Wu HM, Tan TZ, Kuang AR, et al.131I treatment of hyperthyroidism Efficacy Study of Factors Affecting Graves[J].Chin J Nucl Med, 2003, 23(5): 291, 293.
[8] 田志远, 田丽霞, 付秀玲, 等.影响131I首次治疗甲状腺功能亢进症疗效因素分析[J].中华实用诊断与治疗杂志, 2010, 24(2): 206-207.Tian ZY, Tian LX, Fu XL, et al.Effect 131I Hyperthyroidism first treatment efficacy factors[J].J Chin Pract Diagn Ther, 2010, 24(2): 206-207.
[9] Bahn Chair RS, Burch HB, Cooper DS, et al.Hyperthyroidism and other causes of thyrotoxicosis:management guidelines of the American Thyroid Association and American Association of Clinical Endocrinologists[J].Thyroid, 2011, 21(6): 593-646.DOI:10.1089/thy.2010.0417.
[10] 马寄晓, 刘秀杰, 何作祥.实用临床核医学[M].3版.北京:中国原子能出版社, 2012: 288-293.Ma JX, Liu XJ, He ZX.Practical clinical nuclear medicine[M].3rd ed.Beijing:China Atomic Energy Press, 2012: 288-293.
[11] 李少林, 王荣福.核医学[M].7版.北京:人民卫生出版社, 2008: 262.Li SL, Wang RF.Nuclear Medicine[M].7th ed.Beijing:People’s Medical Publishing House, 2008: 262.
[12] 傅宏亮, 杜学亮, 李佳宁, 等.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[J].上海交通大学学报(医学版), 2014, 34(7): 1039-1042.DOI:10.3969/j.issn.1674-8115.2014.07.016.Fu HL, Du XL, Li JN, et al.Calculate dosage regimen row Graves’ disease hyperthyroidism radioactive iodine treatment efficacy[J].Shanghai Jiaotong Univ(Med Edit), 2014, 34(7): 1039-1042.
[13] 武海明, 谭天秩, 匡安仁, 等.131I治疗Graves甲亢近期疗效评价[J].山西医科大学学报, 2002, 33(6): 532-533.DOI:10.3969/j.issn.1007-6611.2002.06.021.Wu HM, Tan TZ, Kuang AR, et al.Short-term effects of radioiodine treatment on Graves’ hyperthyroidism[J].J Shanxi Med Univ, 2002, 33(6): 532-533.
[14] Alexander EK, Larsen PR.High dose of 131I therapy for the treatment of hyperthyroidism caused by Graves’ disease[J].J Clin Endocrinol Metab, 2002, 87(3): 1073-1077.DOI:10.1210/jcem.87.3.8333.

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备注/Memo

备注/Memo:
收稿日期:2016-3-19;改回日期:。
通讯作者:蒋宁一,Email:ningyij@vip.tom.com
更新日期/Last Update: 1900-01-01