不同剂量131I治疗伴高滴度TPOAbTGAbGraves甲亢疗效分析.docVIP

不同剂量131I治疗伴高滴度TPOAb、TGAb的Graves甲亢的疗效分析 　　[摘要] 目的 探讨不同剂量131I治疗伴高滴度TPOAb、TGAb的Graves甲亢的疗效。 方法 将463例伴有高滴度TPOAb、TGAb的Graves甲亢患者根据治疗时每克甲状腺组织所用剂量分为低剂量组（60～75 μCi/g）、中剂量组（80～95 μCi/g）和高剂量组（100～120 μCi/g）。观察三组患者治疗的临床疗效及晚发甲减的发生情况。 结果 三组患者治疗一年后，复查血清游离三碘甲状腺原氨酸（FT3）、血清游离甲状腺素（FT4）及血清超敏促甲状腺素（TSH）均较治疗前有明显改善（P0.05）；三组患者治愈率、晚发甲减率及总有效率比较，差异无统计学意义（P0.05）。 结论 131I治疗伴高滴度TPOAb、TGAb的Graves甲亢，无论是何种剂量，有效率和晚发甲减率均较高，无显著区别。在保障治疗效果的同时应尽量减少每克甲状腺组织的131I的用量，既可以达到很好的治疗疗效，又可以减轻患者的经济负担和对周围的辐射。 　　[关键词] 131I；高滴度TPOAb、TGAb；Graves甲亢；晚发甲减 　　[中图分类号] R581 [文献标识码] A [文章编号] 1673-9701（2017）32-0016-03 　　[Abstract] Objective To investigate the efficacy of different doses of 131I in the treatment of Graves hyperthyroidism with high titer TPOAb and TGAb. Methods A total of 463 Graves hyperthyroidism patients with high titer TPOAb and TGAb were divided into low dose group （60～75 μCi/g）， medium dose group（80～95 μCi/g） and High dose group （100～120 μCi/g）， according to the dose per gram of thyroid tissue used during treatment. The clinical efficacy and the occurrence of late hypothyroidism between the three groups were observed. Results The serum free triiodothyronine（FT3）， serum free thyroxine（FT4） and serum hypersensitive thyrotropin（TSH） after one year of treatment in the three groups were significantly improved compared with that before treatment（P0.05）. There were no significant differences in the cure rate， late hypothyroidism rate and total effective rate between the three groups（P0.05）. Conclusion The effective rate and late hypothyroidism rate of 131I in the treatment with high titer TPOAb， TGAb Graves hyperthyroidism are high， no matter what kind of dose， and there are no significant difference. In the protection of treatment at the same time， the amount of 131I per gram of thyroid tissue should be reduced to the greatest extent， which can not only achieve good therapeutic effect， but also can rduce the economic burden of patients and the surrounding radiation. 　　[Key words] 131I； High titer TPOAb， TGA