131Ⅰ治疗重度甲状腺肿大伴甲状腺功能亢进两种给药方法的分析

目的探讨131I治疗重度甲状腺肿大伴甲状腺功能亢进（serious goiter to accompany hyperthyroidism,SGAH）的两种不同给药方法的治愈率、早发甲低、安全性等综合疗效。方法统计分析口服适量剂量（3.145~3.33 MBq/每克甲状腺组织）的131I行甲状腺减重治疗3~6月后,对减重治疗未愈者按规范每克甲状腺组织给予治疗剂量的131I行第二次治疗的二次给药治疗法（second drugs method,SDM）与对经治患者按131I治疗剂量（4.25~4.65MBq/每克甲状腺组织）结合病史、ATD治疗史、甲状腺硬度、临床症状及体征行131I治疗的一次给药治疗的一次给药治疗法（once drugs method,ODM）之间的治愈率、早发甲低、安全性等综合疗效。结果两组SGAH患者性别、年龄、甲状腺重量、患病病程及两组经二次治疗后总治愈率差异无统计学差异（P〉0.05）;SDM组减重治愈率与ODM组一次治愈率及两组二次治愈率、早发甲低率、SDM组内各甲重组的减重治愈率及二次治愈率、ODM组内各甲重组的一次治愈率及二次治愈率差异具有统计学意义（P〈0.05）。结论 SDM的治疗安全性显著优于ODM,其早发甲低率明显低于ODM,ODM在治愈时间和治疗费用方面优于SDM。

Analysis of Two Methods of Medication in ^131I Treatment of Severe Goiter Patients Associated with Hyperthyroidism

Objective To analyze the clinical effective of two medication methods in the ^131I treatment of severe goiter patients associated with hyperthyroidism. Methods The patients were divided two groups： SDM group （Secondary drug medication） , after taking moderate doses of ^131I （3. 145 -3.33 MBq/per gram of thyroid tis- sue） and applying thyroid weight loss treatment for 3 to 6 months, for the patients not healed a secondary treat- ment by giving them therapeutic doses of 131I according to the specification standard of per gram of thyroid tis- sue; ODM group （Once drug medication） , for these treated patients an once 131I treatment according to the therapeutic 131I dose （4.25 -4.65MBq/per gram of thyroid tissue）. The comprehensive efficacy, including cure rate, early hypothyroidism and safety in SDM and ODM group were analyzed. Results There was no signif- icant difference in the two groups of SGAH patient＇ s gender, age, thyroid weight, disease course and their overall cure rate after secondary treatment （ P 〉 0.05 ）. There were significant differences in the cure rate be- tween the SDM weight loss treatment and the ODM treatment, the two group＇ s secondary medication cure rate and early hypothyroidism rate. Among various thyroid weight groups with SDM, the differences of their weight loss treatment cure rate and secondary cure rate were significant. Also, among various thyroid weight groups with ODM, the differences of their once treatment cure rate and secondary cure rate were significant （P 〈 0.05 ）. Conclusion SDM is significantly superior to ODM, in the treatment security as well as early hypothy- roidism rate. ODM is better than SDM in cure time and cost of treatment.