摘要
目的综合分析 Graves 病^(131)Ⅰ治疗后发生早发甲状腺功能减退(简称甲低)的相关影响因素。方法收集310例 Graves 病行^(131)Ⅰ治疗患者的一般资料、临床观察资料、实验室检查及甲状腺功能检查等资料,采用聚类分析、因子分析、判别分析、多元回归分析等多因素分析方法进行回顾性统计学分析。结果①聚类和因子分析显示,在病程、疗程、发病情况及病情4项临床观察指标中,前3项相关程度高;在促甲状腺激素受体抗体(TRAb)与刺激甲状腺免疫球蛋白(TSI)、甲状腺球蛋白抗体(TgAb)与甲状腺微粒体抗体(TMAb)4项实验室测定指标中,前2项间及后2项间相关程度高,影响作用相似。②Fisher 判别分析显示,在甲状腺质量、有效半衰期、最高吸^(131)Ⅰ率、患者服^(131)Ⅰ剂量和每克甲状腺组织给予平均^(131)Ⅰ剂量5项计量指标中,平均^(131)Ⅰ剂量因素对早发甲低的发生具有判别能力。③Logistic 回归分析显示,在各项^(131)Ⅰ治疗 Graves 病后早发甲低的相关因素中,治疗前甲状腺质量、每克甲状腺组织给予^(131)Ⅰ的平均剂量、甲状腺最高吸^(131)Ⅰ率及 TSI 水平是治疗后出现早发甲低的影响因素。结论 ^(131)Ⅰ治疗 Graves 病后早发甲低的发生可能受多种相关因素影响,在治疗前综合考虑各项影响因素,并对理论剂量适当调整,可在一定程度上减少早发甲低的发生率。
Objective To make a comprehensive analysis of the related factors of early hypothyroidism occurring in patients with Graves＇ disease after ^1311 treatment. Methods The information of ^131I treated Graves＇disease was collected including general data, clinical observation, laboratory data, thyroid function test, etc. Then a retrospective statistical analysis was carried out, using cluster analysis, factor analysis, discriminant analysis, multivariate regression analysis, etc. Results ①Cluster analysis and factor analysis showed that among clinical observation such as clinical course, treatment course, patients＇ state and disease occurrance,the first three factors correlated highly; among laboratory data such as thyrotrophin receptor antibody （ TRAb）, thyroid-stimulating immunoglobulins（ TSI）, thyroglobulin antibody （TgAb） and thyroid microsomal antibody （TMAb） , both the first two and the last two correlated highly, each two factors had the similar effect. ②Fisher discriminant analysis showed that among the thyroid weight, the effective half life, the maximum ^131I uptake percentage, total dose of ^131I and the average dose of ^131I per gram of thyroid, the last one had the most predicting value for incidence of early hypothyroidism. ③Logistic regression analysis showed that among all the related factors of early hypothyroidism occurred after ^131I treated Graves＇ disease, thyroid weight, average dose of ^131I per gram of thyroid, the maximum ^131I uptake percentage and the level of TSI were effective factors. Conclusions The occurrence of early hypothyroidism for ^131I-treated Graves＇ disease is probably affected by many factors. If more factors are taken into consideration before therapy and the theraputic dose is well adjusted accordingly, it can reduce the incidence of early hypothroidism to a certain extent.
出处
《中华核医学杂志》
CAS
CSCD
北大核心
2005年第6期325-328,共4页
Chinese Journal of Nuclear Medicine
