131I治疗对分化型甲状腺癌患者临床效果的研究

目的 探讨131I治疗对分化型甲状腺癌的疗效及对机体血细胞、肝肾功能、唾液腺的分泌与排泄功能的影响.方法 回顾性分析73例手术后接受131I治疗的分化型甲状腺癌患者的临床资料.患者单次口服131I剂量为3.96～8.20 GBq,治疗后3个月评估疗效.采用发光免疫分析方法和唾液腺ECT显像检测治疗前后的血细胞[白细胞(WBC)、血小板(PLT)、淋巴细胞(LC)、红细胞(RBC)]、肝肾功能指标[血清丙氨酸氨基转移酶(ALT)、血清天冬氨酶氨基转移酶(AST)、血肌酐(Cr)、血尿素氮(BUN)、血清碱性磷酸酶(ALP)]以及唾液腺功能指标[15 min摄锝率(UR15)和最大排泄量(MS)].分析131I对血细胞、肝肾功能、唾液腺的分泌与排泄功能的影响.结果治愈率为23.29％,有效率为80.82％,无效率为19.18％.治疗前后患者的RBC水平比较,差异无统计学意义(P﹥0.05);治疗后患者的WBC、PLT和LC水平均较治疗前明显降低(P﹤0.01).治疗前后患者的ALT、AST、Cr、BUN及ALP水平比较,差异无统计意义(P﹥0.05).治疗后患者双侧腮腺的UR15和MS均明显降低(P﹤0.01),双侧颌下腺的UR15和MS无明显变化(P﹥0.05).结论131I对分化型甲状腺癌有较好的疗效,对血细胞、肝肾功能、唾液腺的分泌与排泄功能有不同程度的轻微损伤,可为临床最佳剂量的选择提供一定的参考.

Clinical effect of 131I treatment in differentiated thyroid cancer patients

Objective To explore the efficacy and effect of 131I radiotherapy on blood cell count, liver and kidney function, and parotid function in patients with differentiated thyroid cancer (DTC). Method 73 patients with DTC ad-ministered with 131I at the dose of 3.96-8.20 GBq after thyroid cancer surgery were analyzed retrospectively. Efficacy was evaluated in 3 months after treatment. Blood cell count (WBC, PLT, LC and RBC), and liver and kidney function (ALP, ALT, AST, BUN and Cr) were detected with the immunofluorescent analysis method. Parotid function (UR15 and MS) was evaluated using ECT imaging. The effect of 131I radiotherapy on blood cell count, liver and kidney function, and parot-id function were analyzed. Result The cure rate was 23.29％, response rate was 80.82％, and 19.18％patients were with no response. There were no significant change in RBC before and after treatment (P>0.05);however, the count of WBC, PLT and LC significant reduced after treatment (P<0.01). Liver and kidney function indices (ALT, AST, Cr, BUN and ALP) were similar before and after treatment (P>0.05). The value of UR15 and MS in both parotids significant reduced after 131I radiotherapy (P<0.01). However, the value of UR15 and MS in bilateral submandibular gland was of no obvious change after 131I radiotherapy (P>0.05). Conclusion 131I radiotherapy is an effective therapy for DTC, and may induce dif-ferent degrees of slight damage on blood cell count, liver and kidney function, and parotid secretion and excretion, which may be the reference for selecting optimal clinical doses.