甲亢手术与丙基硫氧嘧啶对131I疗效的影响

目的 探讨甲亢术后复发和丙基硫氧嘧啶（PTU）治疗后对^131I疗效的影响。方法 2003年1月至2004年12月在我院核医学科治疗的甲亢术后复发病人，未经过抗甲状腺药物治疗41例为术后复发组；按同时期^131I治疗次序编号，从未经过手术及抗甲状腺药物治疗的病例中随机抽取41例为对照组（未治疗组）；从只经PTU治疗的病例中随机抽取41例为PTU组，采用标准剂量法给予^131I治疗，分析治疗后3与6个月随访资料。结果 未治疗组^131I治疗后3和6个月甲亢治愈率分别为90．24％（37141）和92．68％（38/41），无效率分别为9．76％（4／41）和7．32％（3／41）；PTU治疗组^131I治疗后3和6个月甲亢治愈率分别为43．90％（18／41）和53．66％（22／41），无效率分别为56．10％（23／41）和46．34％（19／41），与未治疗组比较均为P〈0．01；术后复发组^131I治疗后3和6个月甲亢治愈率分别为68．29％（28／41）和70．73％（29／41），无效率分别为31．71％（13／41）和29．27％（12／41），与未治疗组比较均为P〈0．05。结论 甲亢在^131I治疗前经外科手术或PTU治疗，将影响^131I治疗效果，降低甲亢^131I的治愈率。

Iufluence of surgical or propylthiouracil pretreatment on the efficacy of iodine-131 therapy in hyperthyroidism

Objective To investigate the influence of surgical or propylthiouracil(PTU) pretreatment on the efficacy of radioactive iodine therapy in hyperthyroidism. Methods A group(group 1) of 41 hyperthyroidism patients relapsed after surgery were treated with ~(131)I in our department from 2003 through 2004. During that period,another group(group 2) of 41 cases were selected randomly from patients untreated either surgically or chemically before oral administration of ~(131)I,and a third group(group 3) of 41 cases were selected randomly from those pretreated only with PTU.We analysed the results of these three groups of patients after followed_up for 3 and 6 months separately after ~(131)I therapy. Results Approximately 90.24%(37/41 cases) and 92.68%(38/41 cases) of patients in group 2 without any pretreatment were cured 3 months and 6 months after ~(131)I treatment,respectively,and 9.76%(4/41 cases) and 7.32%(3/41 cases) of them did not respond to ~(131)I treatment.About 43.90%(18/41 cases) and 53.66%(22/41 cases) of patients pretreated with PTU(group 3)were cured at 3 and 6 months,respectively,and approximately 56.10%(23/41 cases) and 46.34%(19/41 cases) of this group patients did not respond to ~(131)I treatment at 3 and 6 months,respectively(P<0.01) compared with the un_pretreated group.About 68.29%(28/41 cases) and 70.73%(29/41 cases) of relapsed patients after surgery(group 1) were cured at 3 and 6 months after ~(131)I treatment,respectively,and 31.71%(13/41) and 29.27%(12/41) of them did not respond to ~(131)I treatment(P<0.05) as compared with the unpretreated group. Conclusion (Surgery or PTU) pretreatment of hyperthyroidism patient before ~(131)I treatment can affect the efficacy of ~(131)I therapy,resulting in reduction of the cure rate.