摘要
目的评价131I治疗甲状腺功能亢进(甲亢)患者的疗效,分析影响疗效的因素以及甲状腺功能减低(甲减)发生的情况。方法回顾性分析2003年~2007年行131I治疗、且有完整随访资料的162例甲亢患者。治疗方法:对已确诊的甲亢患者,进行131I治疗前相关准备,确定无131I治疗禁忌证后,根据甲状腺重量和24 h摄碘率计算131I的给药剂量,并结合患者实际病情调整131I的给药剂量和疗程。治疗后1、3、6个月随访。结果该组患者总治愈率为72.2%,总有效率100.0%;一次治愈率56.8%,一次有效率97.5%;治疗后1个月大部分患者血FT3和FT4水平有不同程度降低;不同性别之间疗效差异无统计学意义,患者年龄大、病程长、甲状腺重量大、质地偏硬2、4 h摄碘率高、甲亢合并突眼时疗效较差,131I治疗前所使用的治疗方法也对疗效有影响;甲减的发生与性别、年龄、病程等因素无关,24 h摄碘率较低、甲状腺体积较小者容易发生甲减。结论 131I治疗甲亢疗效好,可作为绝大多数甲亢患者的首选治疗方法,但其疗效受多种因素影响,需根据患者具体情况确定131I治疗剂量。
Objective To evaluate the therapeutic effect of 131I therapy in patients with hyperthyroidism,and analyze the factors which could influence the curative effect and hypothyroidism occurrence.Methods We retrospectively studied 162 patients with definite diagnosis of hyperthyroidism receiving 131I treatment from 2003 to 2007.All patients had complete follow-up data,and had no contraindication for 131I therapy.The dose of 131I was calculated and adjusted according to the weight of thyroid,the iodide uptake rate and patient condition.The regular follow-up was 1,3 and 6 months after treatment.Results Total curative rate of 162 patients was 72.2%,and the total effective rate was 100.0%.After one period of treatment,the curative rate was 56.8%,and the effective rate was 97.5%.The levels of serum FT4 and FT3 in most patients were decreased one month after 131I treatment.Gender was not an influencing factor on therapeutic effect,but the treatment before 131I therapy was an important one.The patients with worse effect always had the following conditions：older,longer disease course,bigger and/or hard thyroid,higher 24-h 131I uptake rate and exophthalmos.Hypothyroidism occurrence had little relationship with gender,age and the course of disease.Patients with lower 24-h 131I uptake rate or smaller thyroid were prone to hypothyroidism.Conclusion The curative effect of 131I therapy for hyperthyroidism was satisfactory,and it could be used as the first line therapy for most hyperthyroidism patients.However,individualized treatment should be applied for there were many factors that could influence the therapeutic effects.
出处
《华中科技大学学报（医学版）》
CAS
CSCD
北大核心
2010年第6期845-850,共6页
Acta Medicinae Universitatis Scientiae et Technologiae Huazhong
