放射性核素~(131)I治疗Graves病的近期疗效分析

目的:了解放射性核素131碘(131I)治疗Graves病的近期疗效及甲状腺机能减退(甲减)的发生情况。方法:对我院523例接受131I治疗的Graves病患者,在治疗后分别进行了近期随访,随访时间为9～24月。根据其临床症状、体征及用化学发光免疫分析法测定血清FT3、FT4、sTSH的浓度,对患者的治愈率及甲减发生率进行统计分析。结果:在访的380例病人中,一次治愈率69.0%,二次治愈率为75.0%,总治愈率为78.7%;甲减发生率一次治疗为28.3%,二次治疗为38.5%。结果显示,一次、二次治疗治愈率及甲减发生率差异无显著性(P>0.05),无1例发生甲亢危象。结论:131I治疗Graves病安全可靠,疗效确切;甲减是其主要的不良反应;二次治疗不增加甲减的发生率,故一次治疗未愈者仍可考虑行二次131I治疗。

Short-term effect of radionuclide 131I in Graves disease

Objective：To find out the short-term effect of ^131I in treatment of Graves disease（GD） and the incidence of hypothyroidism. Methods：A total of 523 patients with GD underwent treatment of ^131 I. After that, all patients received follow-up ranging from 9 to 24 months and were reviewed in terms of physical signs and symptoms. Chemiluminescence immunoassay was used to determine the concentration of FT3 , FT4 and sTSH for curative rate and incidence of hypothyroidism. Results： Of 380 patients, the follow-up showed that 69.0% recovered from the first treatment and 75.0% required secondary medication ,but in general 78.7% responded to the therapy. Also, the incidence of hypothyroidism was found in 28.3% of the patients during the first treatment,but 38.5% for the secondary therapy. The findings revealed no significant difference between the first and second curative rate and no single case of hyperthyioidism crisis （ P 〉 0.05 ）. Conclusion ：The single dose of ^131I treatment is highly effective and safe for GD except for the incidence of hypothyroidism, the leading side effects from this agent. Secondary treatment can be favorable under the failure of the initial action since another medication will not cause greater incidence of hypothyroidism.