摘要
目的探讨单次^(131)I治疗甲状腺功能亢进症(甲亢)的疗效及5年内甲状腺功能减退症发生率(甲减率)与复发率的变化规律。方法收集接受^(131)I治疗的317例患者的临床资料,其中为单次^(131)I治疗后的患者纳入疗效的全部资料,若为多次^(131)I治疗患者则仅纳入第1次疗效的资料,比较不同性别患者的疗效及不同年龄段(≤29岁组、30~49岁组及≥50岁组)男女患者的甲减率,计算随访5年内的复发率。结果 317例治疗后半年总有效率为92.7%(治愈率46.1%、甲减率35.3%、好转率11.3%),无效率为7.3%、复发率为0%。女性的疗效优于男性(P<0.001)。治疗后半年,≤29岁组女性患者甲减率高于男性(P<0.05),女性患者中不同年龄段患者甲减率比较差异有统计学意义(P<0.05),其中≤29岁组的女性患者甲减率均高于30~49岁组及≥50岁组女性患者(P均<0.05)。连续随访5年的患者共154例,^(131)I治疗后半年、3年时男女患者的甲减率比较差异均无统计学意义(P均>0.05)。而^(131)I治疗后1、5年时女性患者甲减率均高于男性患者(P均<0.05)。^(131)I治疗后半年及1、3、5年患者总体的甲减率分别为37.0%、42.2%、44.2%及47.4%,随时间变化总体呈增高趋势。^(131)I治疗后1、3及5年复发率分别为0.6%、1.3%及1.3%。结论^(131)I治疗甲亢疗效肯定,女性青年患者甲减率高于中老年患者。随访至1、5年时,女性甲减率高于男性。治疗后5年内患者甲减率呈逐年增高的趋势,而复发率一直维持极低水平。
Objective To evaluate the clinical efficacy of single 131I therapy in the treatment of hyperthyroidism and explore the changing pattern of hypothyroidism rate and recurrence rate in 5-year follow-up. Methods Clinical data of 317 patients with hyperthyroidism treated with 131I therapy were collected. Among them, all clinical data of patients receiving single 131I therapy were included. For those receiving multiple 131I treatment, the clinical data during the first therapy were obtained. During 5-year follow-up, the hypothyroidism rates were statistically compared according to age （≤29, 30-49 and ≥50 years old） and gender （male and female）, the recurrence rates were calculated. Results At 6 months after single radioiodine therapy, the overall effective rate was 92.7% （46.1% for cure rate, 35.3% for hypothyroidism rate and 11.3% for improvement rate）, the ineffective rate was 7.3% and the recurrence rate was 0%.The clinical efficacy in female patients was significantly higher than that in their male counterparts （P 〈 0.001）. At 6 months after corresponding treatment, the hypothyroidism rate in female patients aged ≤29 years was significantly higher than those in their male counterparts （P 〈 0.05）. The hypothyroidism rate significantly differed in female patients according to age （P 〈 0.05）.The hypothyroidism rate in female patients aged ≤29 years was significantly higher compared with those in their counterparts aged 30-49 and ≥50 years （both P 〈 0.05）. In total, 154 patients were followed up for 5 years. The hypothyroidism rate did not significantly differ between male and female patients at 6-month and 3-year after 131I treatment （both P〉0.05）. At 1- and 5-year following 131I therapy, the hypothyroidism rate in female patients was significantly higher than that in male counterparts （both P 〈 0.05）. At 6-month, 1-, 3- and 5-year after 131I therapy, the overall hypothyroidism rate was 37.0%, 42.2%, 44.2% and 47.4%, respectively, which tended to increase over
作者
李建芳
秦露平
谢良骏
刘思安
刘彤
程木华
Li Jianfang;Qin Luping;Xie Liangjun;Liu Sian;Liu Tong;Cheng Muhua(Department of Nuclear Medicine,the Third Af filiated Hospital of Sun Yat-sen University,Guangzhou 510630,China)
出处
《新医学》
2018年第9期656-659,共4页
Journal of New Medicine
基金
2013年广东省大学生创新训练项目(1055813228)
