131碘治疗甲状腺癌患者后唾液腺功能的变化分析

目的了解分化型甲状腺癌(DTC)患者在接受不同剂量的131碘治疗后唾液腺功能的变化情况。方法将44例DTC术后患者分为4组,Ⅰ组为未治疗的患者10例,Ⅱ组为第1次治疗后患者16例,使用131碘剂量2.96～3.70 GBq;Ⅲ组为2次治疗后的患者12例,累积剂量8.51～11.10 GBq;Ⅳ组为3次治疗后的患者6例,累积剂量14.06～18.50GBq;对所选患者进行放射性核素唾液腺动态显像,根据所得的时间放射性曲线定量分析患者的唾液腺功能参数。结果①未行131碘治疗的DTC术后患者的唾液腺显像清晰,唾液腺的时间-放射性曲线上升明显,酸刺激后迅速下降;但大剂量131碘治疗后唾液腺功能明显降低的DTC术后患者唾液腺显像模糊,唾液腺的时间-放射性曲线上升缓慢,酸刺激后缓慢下降。②Ⅱ、Ⅲ组与Ⅰ组间腮腺及颌下腺的摄取分数(UR)、酸刺激后唾液腺排泌分数(ER)的比较差异均无统计学意义,而Ⅳ组患者UR、ER均较Ⅰ组降低(P<0.05)。结论 3次大剂量131碘(累积剂量14.06～18.5GBq)治疗后的DTC患者唾液腺功能受损,其摄取和排泄功能均降低。

The variation of salivary gland function in patients with thyroid carcinoma after 131I treatment

Objective To investigate the variation of salivary gland function in patients with differentiated thyroidcarcinoma(DTC) after different doses of 131I treatment.Methods 44 patients with DTC were divided into four groups.GroupⅠ,10 cases treated with DTC after thyroid ablation.GroupⅡ,16 cases treated with DTC after once therapy by 2.96～3.70 GBq 131I.Group Ⅲ,12 cases treated with DTC after 2 times therapy by a total radioactivity of 8.51～11.10 GBq 131I.Group Ⅳ,6 case treated with DTC after 3 times therapy by a total radioactivity of 14.06～18.50 GBq 131I.Salivary gland scintigraphy was performed in all above patients.According to the time radioactivity curve,function parameters of salivary glands were analysed quantitatively.Results ① The images of salivary glands were clear and the time-radioactivity curves of salivary gland increased significantly and decreased rapidly after acid stimulation.However,after 131I treatment,the images of salivary glands were blurred with function depressed significantly and time-radioactivity curves of salivary glands increased slowly and decreased slowly after acid stimulation.② There was no statistical difference in uptake ratio and excretion ratio of parotid and submandibular glands between group Ⅱ,Ⅲ and groupⅠ.However,these parameters decreased in group Ⅳ compared with those in groupⅠ(P<0.05).Conclusion The salivary function(including uptake ratio and excretion ratio) reduces in patients with DTC after 3 times therapy by a total radioactivity of 14.06～18.50 GBq 131I.