欢迎访问《同济大学学报（医学版）》编辑部！

引用本文：

马玉波,徐枫,远奇.131I治疗Graves病无效和复发的相关因素分析[J].同济大学学报（医学版）,2016,37(4):78-82. [点击复制]
MA Yu-bo,XU Feng,YUAN Qi.Factors related to failure or recurrence of patients with Graves' disease undergoing ¹³¹I[J].同济大学学报（医学版）,2016,37(4):78-82. [点击复制]

【打印本页】【在线阅读全文】【下载PDF全文】【查看/发表评论】【下载PDF阅读器】【关闭】

本文已被：浏览 479次下载 425次	码上扫一扫！
131I治疗Graves病无效和复发的相关因素分析
马玉波,徐枫,远奇
0 字体:加大+\|默认\|缩小-
(上海交通大学医学院附属第九人民医院核医学科,上海 200011)

摘要:

目的回顾性分析¹³¹I治疗Graves'病(Graves' disease, GD)后无效和复发病例的相关因素。方法门诊治疗GD患者441例,其中男性128(29.0%)例,女性313(71.0%)例,平均年龄(41.7±13.3)岁。依据摄¹³¹I率公式并结合临床经验确定¹³¹I剂量,一次给药。根据¹³¹I首次治疗效果分为A组(好转+治愈)399例(90.5%)、B组(无效+复发)42例(9.5%)。对未愈或复发者,相隔3个月以上同法重复治疗,直至痊愈。结束治疗后随访1年以上,分析两组年龄性别等相关因素的差异及临床意义。结果两组在性别、年龄、24h摄¹³¹I率、自身免疫性抗体水平、甲状腺质量和质地上的差异均无统计学意义(P>0.05)。两组治疗前A组的FT₃和FT₄水平明显高于B组(t=2.5084和2.1303,P<0.01)；A、B两组病程分别为(70.5±64.1)和(120.9±114.4)个月(t=-2.7274,P<0.01)；两组抗甲状腺药物(antithyroid drugs, ATD)治疗时间分别为(28.7±22.6)和(61.1±54.9)个月,差异有统计学意义(t=-4.0017,P<0.01)；两组晚发甲状腺功能减退分别为201例(50.4%)和21例(50.0%),差异无统计学意义(χ²=0.0134,P>0.05)。病程和ATD治疗时间与累计首次治愈率都呈负相关(P<0.001)。结论病程长、ATD治疗时间长导致甲状腺对¹³¹I的敏感性下降,可能是¹³¹I治疗GD无效和复发的关键影响因素。

关键词: ¹³¹I Grave's病抗甲状腺药物疗效

DOI：10.16118/j.1008-0392.2016.04.016

投稿时间：2015-11-20

基金项目:

Factors related to failure or recurrence of patients with Graves' disease undergoing ¹³¹I

MA Yu-bo,XU Feng,YUAN Qi

(Dept. of Nuclear Medicine, Ninth People's Hospital, Medical School, Shanghai Jiaotong University, Shanghai 200011, China)

Abstract:

ObjectiveTo analyze the factors related to treatment failure or disease recurrence of patients with Graves'disease (GD) undergoing ¹³¹I therapy. Methods Four hundred and forty one GD patients were treated by ¹³¹I, including 128(29%) men and 313(71%) women, aged(41.7±13.3) years. The therapy was repeated after 3 months for patients who were not cured or had recurrence were followed up for more than one year. They were 399(90.5%) effective and cured patients (group A) and 42(9.5%) ineffective and recurrent patients (group B) after the first therapy. The factors related to treatment failure or disease recurrence were analyzed. Results There were no significant differences in gender, age, 24h thyroid ¹³¹I uptake(%), level of autoantibodies before ¹³¹I therapy, the mass and hardness of the thyroid and the dose of ¹³¹I administrated at the first time between two groups. Compared to group A, group B had longer disease duration (70.5±64.1 vs 120.9±114.4 months, t=-2.7274, P<0.01) and longer anti-thyroid drugs (ATD) pretreatment (28.7±22.6 and 61.1±54.9 months, t=-4.0017, P<0.01), lower FT₃ and FT₄ levels (t=2.5084,t=2.1303, P<0.01), but no significant difference in rate of permanent hypothyroidism [50.4%(201/399) vs 48.8%(21/42), χ²=0.0134, P>0.05]. Conclusion Long disease duration and long ATD pretreatment may result in ¹³¹I treatment failure or disease recurrence in GD patients.

Key words: ¹³¹I Graves' disease Antithyroid drugs curative effect