摘要
目的 前瞻性探讨首次131I清除甲状腺残余组织（简称清甲）治疗对DTC患者唾液腺功能的影响及口服维生素E对唾液腺的保护作用.方法 随机选择2014年3月至2015年12月天津医科大学总医院核医学科60例DTC术后患者进入对照组（男10例,女20例,年龄26 ～ 69岁）和试验组（男8例,女22例,年龄31～75岁）,均为术后首次服131I患者（剂量3.7 GBq）;其中对照组无需特殊准备,而试验组需于服131I前1周至服131I后1个月口服维生素E.2组患者分别于服131I前4h及服131I后6个月行2次99TcmO4-唾液腺显像,计算摄取分数（UF）、摄取指数（UI）、排泌分数（EF）、排泄率（ER）等参数,以评估唾液腺功能变化.应用配对样本t检验及两样本t检验进行统计学分析.结果 对照组治疗后双侧腮腺UF及双侧颌下腺UF、UI均大于治疗前（t=2.525～ 3.335,均P＜0.05）.试验组治疗后右侧颌下腺UI、EF及左侧颌下腺UF、UI、ER均小于治疗前（t=-4.704～-2.364,均P＜0.05）.治疗前,试验组双侧腮腺UF、右侧颌下腺UI及左侧颌下腺UF、UI均高于对照组（=-6.507～-1.794,均P＜0.05）;治疗后,试验组双侧腮腺UI均高于对照组（t=-2.134和-2.462,均P＜0.05）.结论 首次131I清甲治疗可能会对唾液腺的储备功能造成损害,口服维生素E可以减轻这一影响,在一定程度上起到保护唾液腺的作用.
Objective To evaluate the impact of first 131I remnant ablation and the protective effect of vitamin E to salivary gland function of patients with DTC.Methods A total of 60 DTC patients from March 2014 to December 2015 were enrolled in this prospective study.Before the first ablation therapy with 3.7 GBq 131I after total thyroidectomy,patients were randomly divided into two groups：control group （10 males,20 females,age range：26-69 years） and vitamin E group （8 males,22 females,age range：31-75 years）.All patients in vitamin E group received vitamin E for a duration of 1 week before to 1 month after the administration of 131I.The patients in control group required no special preparation.Salivary gland function was assessed using salivary gland scintigraphy in two phases （4 h before and 6 months after the administration of 131 I）.Quantitative parameters including uptake fraction （UF）,uptake index （UI）,excretion fraction （EF） and excretion ratio （ER） were measured and compared between the two groups.Paired t test and two-sample t test were used for statistical analysis.Results When compared between preablation and postablation,UF of both parotid glands and UF,UI of both submandibular glands were significantly increased in the control group （t=2.525-3.335,all P〈0.05）.And UI,EF of right submandibular gland and UF,UI,ER of left submandibular gland were significantly decreased in vitamin E group （t=-4.704--2.364,all P〈 0.05）.When compared between vitamin E group and control group,preablative UF of both parotid glands,UI of right submandibular gland and UF,UI of left submandibular gland in study group were significantly higher than those of control group （t =-6.507--1.794,all P〈 0.05） and postablative UI of both parotid glands in vitamin E group were also significantly higher than that of control group （t=-2.134 and-2.462,both P〈0.05）.Conclusions The first 131I ablative therapy may impair the salivary reserve function.Vitamin E may play a protective role by relieving this impact.
出处
《中华核医学与分子影像杂志》
CAS
北大核心
2016年第5期398-401,共4页
Chinese Journal of Nuclear Medicine and Molecular Imaging
