131I治疗分化型甲状腺癌的副作用的随访研究

为分析和评价131I治疗分化型甲状腺癌的副作用，对342例分化型甲状腺癌术后接受了131I治疗的患者进行了随访研究。眼药后急性反应被记录；出院后定期随访血常规，肝肾功能，延腺功能及有无与131I治疗相关的远期副反应。随访时间1～10年，平均5．4年。结果：放射性甲状腺炎主要发生在吸131I率＞30％的患者；放射性涎腺炎主要发生在吸131I率＜30％的患者；常见的消化道反应：恶心12．2％；呕吐5．2％；腹泻3．5％；胃痛2．7％。Plt、WBC和Hb治疗前后无显著性差异（P＞0．05）；一过性血小板减低和一过性WBC减低总发生率分别为10．4％和4．0％；但131I碘累积剂量＞18．5GBq的患者其发生率明显高于累积剂量＜18．5GBq的患者（P＜0．01）；无远期副反应。以上结果表明本组患者近期副作用发生率低，无远期副作用，提示131I治疗分化型甲状腺癌是安全可行的。

Evaluation of Side-Effects after 131I-therapy for Differentiated Thyroid Carcinoma

The purpose of this study was to evaluate the side-effects of differentiated thyroid carcinoma after treatment with 3. 7-7. 4 GBq of 131I. A total of 342 patients were treated with 131I from May, 1989 to January,1999.The acute side-effects, the short-term and long-term side-effects were ana1yzed. The follow-up lasted 1-10 years with an average of 5. 4 years.The results showed that thyroiditis occurred'predominantly in the patients with a rate of 131I uptake >30%, whereas sialoadenitis occurred more prevalently in the patients with a rate of 131I uptake <30% (P<0.001). The rates of nausea, vomiting, diarrhea and gastralgia were 12. 2%, 5. 2%, 3. 5%and 2. 7% respectively. There were no significant changes in the hemogram after treatment, compared against that before treatment. The overall rates of transient platelet abnormalities and leukopenia were 10. 4% and 4.0%respectively, but the rates of the abnormalities in the patients with cumulative doses of 131I>18. 5GBq were significantly higher than those in patients with cumulative doses of 131I<18. 5GBq. The lower rate of acute and short-term side-effects and the absence of long-term side-effects in this study indicate that 131I can be safely used to treat differentiated thyroid carcinoma.