Graves'病131I治疗剂量及甲低与TGA、TMA的关系

目的:从甲状腺自身免疫方面探讨Graves'病131I治疗剂量及甲低的发生因素.方法:选择131I治疗的176例Graves'病患者随访3年,分为第Ⅰ组(TGA、TMA阳性)和第Ⅱ组(TGA、TMA阴性).采用χ2分析自身抗体水平与131I治疗剂量及甲低发生的关系.结果:Ⅰ组甲低发生率为31.4%,Ⅱ组为3.8%,Ⅰ组明显高于Ⅱ组,差异有显著性(P＜0.05).结论:TGA、TMA水平与确定131I剂量及甲低的发生关系密切.认为TGA、TMA水平高的患者应酌情减少131I用量.

Relationship Between the Serum TGA,TMA Positiveness and Development of Hypothyroidism After 131I Therapy in Patients with Graves''''Disease

Objective To study the likelibood of development of hypothyroidism after ~(131)I therapy in patients with Graves' disease as related to the serum positiveness of TGA and TMA before treatment.Methods Altogether,176 patients with Graves' disease were treated with ~(131)I and followed for 3 years of these patients,serum TGA and TMA were positive in 70 and were negative in 106.Results In the 70 patients with positive TGA and TMA,development of hypo-thyroidism after ~(131)I treatment occurred in 22 subjects three years later(31.4%).However,only 4 of the 106 patients with negative TGA and TMA developed hypothyroidism 3 years after ~(131)I therapy(3.8%).Difference in the incidence of hypo thyroidism was significant(P<0.05).Conclusion It is suggested that a lower dose of ~(131)I be administered to patients with Graves' disease and positive serum TGA,TMA.