不同剂量131 碘治疗Graves 甲状腺功能亢进与前瞻性随机对照研究.docVIP

不同剂量131碘治疗Graves甲状腺功能亢进的前瞻性随机对照研究 吴平 李华 易吉秀 凌冰 李凌 陈焕梅 容若慧子（重庆黔江中心医院内分泌科，重庆 409000） [摘要]：目的 观察2种剂量131碘治疗Graves甲亢652例符合入选标准的Graves甲状腺功能亢进患者分为两组，分别按照每克甲状腺射性活度60-100 μCi/g（小剂量组）、80-120μCi/g（常规剂量组）计算给予131碘治疗剂量。随访12个月，观察两组一次性有效率及治疗后甲减发生率。8例浸润性突眼患者131碘治疗后给予强的松0.5 mg/kgraves甲亢raves甲亢131碘与常规131碘剂量治疗甲亢一次性有效率无差别，而甲减发生率明显降低，在甲状腺功能亢进治疗中，适当调低常规治疗剂量可能是更加合理的治疗方法。 [关键词]：Graves；甲状腺功能亢进；131碘治疗；剂量；治疗结局 Therapeutic effect of 131-iodine at 2 different doses for Graves’ disease: a randomized controlled trial Wu Ping, Li Hua, Yi Jimei, Ling Bing, Li Ling, Chen Huanmei, Rong Ruohuizi (Department of Endocrinology, Qianjiang Central Hospital, Chongqing, 40900, China) Abstract：Objective To 131-iodine (131-I) at 2 different doses on the treatment of Graves’ hyperthyroidism, and investigate the influence factors and complications. Methods A randomized controlled trial was conducted on 652 Graves’ hyperthyroidism patients who were admitted in our hospital from September 2006 to June 2010. These patients were prospectively assigned into 2 matched groups, low-dose group (n=330, receiving a calculated dose of 60–100 μCi/g 131-I), and conventional dose group (n=322, receiving 80–120 μCi/g 131-I ). Patients were followed up for 12 months and considered as in remission when they were in a stable euthyroid state. Primary efficiency and incidence of hypothyroidism were compared between the 2 groups. Prednisone was given to 8 patients with infiltrative ophthalmopathy at a daily dose of 0.5 mg/kg for 1 month during radioiodine therapy. Results The remission rate was lower in low dose group (80.0%) than in the conventional dose group (82.9%), but no difference was found. The incidence of hypothyroidism was significantly lower in the low dose group than the conventional dose group (10.6% vs 16.7%, P0.05). There was no correlation among clinical features, thyroid uptake, antibody levels, and serum hormones levels with outcome. For the patients having infiltrative ophthalmopathy, their symptoms did not become