131I治疗Graves病疗效及影响因素研究.doc

131I治疗Graves病疗效及影响因素研究[摘要] 目的：探讨131I治疗Craves病（GD）的最佳剂量方法并分析其中影响疗效的因素。方法：155例GD患者按最佳公式计算131I剂量。治疗前后进行示踪和治疗剂量的甲状腺摄碘率（TUR）和有效半衰期（EHL）测量，甲状腺重量采用显像（RI）及B超（US）重复测量。结果：131I治疗前后24 h TUR和EHL综合影响为1.08。甲状腺重量下降率与治疗前重量关系呈弱正相关。临床治愈率为71.0％、未愈为29.0％。TGAb、TMAb阳性与阴性组比较正常、甲减和未愈均有差异。结论：GD131I疗效受不同给药方法的影响，甲状腺重量是最重要的一个参数。治疗前后TUR和EHL综合影响为1.08。甲状腺抗体在甲减的发生、发展过程中起一定的作用。迅速控制甲亢，而又要降低甲减率，难以兼顾。 [关键词] 格雷夫斯病；放射性核素显像；超声检查；碘放射性同位素；甲状腺重量；放射疗法 [中图分类号] R816.6[文献标识码]A [文章编号]1673-7210（2008）06（c）-017-03 Effective of radioiodine therapy of Graves disease and affecting factors ZHOU Xin-jian, WEI Lai, YANG Xiao-hui （Department of Nuclear Medicine，Dongfang Hospital, Beijing University of Chinese Medicine and Pharmacology, Beijing 100078, China） [Abstract] Objective:The aim of this object was intended to optimize radiation dose for iodine-131 to treatment Graves’disease（GD）and analyzed possible factors affect outcome．Methods:155 patients with GD were selected. Determined 131I tracer thyroid uptake（TUR）＆ effective half-life（EHL）．Thyroid weight was estimated by radionuclide imaging（RI）＆ ultrasound（US）before ＆after 131I therapy repeat examined. The TUR＆EHL of 131I therapy dose．Thyroid function was determined by serum＆ thyroid antibody．Results:The TUR ,EHL of tracer dose＆therapeutic, were lower 1.04×1.04=l.08．the thyroid weigh of the patients repeat after 131I treatment was significantly decreased. Followed up, 110 patient appeared euthyroid 71.0％，23 became latent hypothyroidism l4.8％，45 were still hyperthyroidism.TGAb（TMAb）positivewere difference negitiveive.Conclusion: There are facts affects 131I therapy：the formulas of calculations is choice．Thyroid weight are main factor. The TUR＆EHL of therapeutic are lower than racer dose，if 1.08 use to correct the dose of therapeutic dose，persistent hyperthyroidism will reduce in this object；TGAb（TMAb）playis some role in hypothyroidism development; actual dose of 131I solution＆capsule is discrepancy from expect dose．Used 131I dose calculated by optimizefo