摘要
目的探讨甲状腺摄碘率和^(99)Tc^(m)显像与Graves甲亢^(131)I治疗疗效的相关性。方法回顾性分析132例Graves甲亢患者,按甲状腺24 h摄碘率分为A组(≤50%).B组(50%~80%).C组(≥80%),按照摄碘率曲线趋势分为高峰前移组(6h/24h摄碘率比值>1)和无高峰前移组(6 h/24 h摄碘率比值≤1),根据甲状腺^(99)Tc^(m)显像质量分为1组(≤30 g)、2组(30-60g)、3组(≥60g)。比较不同类型分组患者^(131)I治疗效果。结果132例患者首次^(131)I治疗后随访6个月,总有效率为88.6%(117/132),总治愈率为78.0%(103/132),未愈率为22.0%(29/132)。三组不同24 h摄碘率患者治疗后血清甲状腺素水平均较治疗前明显降低(P均<0.05),甲状腺24h摄碘率越低,治疗后血清总三碘甲状腺原氨酸(TT3)、总甲状腺素(TT4)、游离三碘甲状腺原氨酸(FT3)和游离甲状腺素(FT4)水平降低越显著,促甲状腺激素(TSH)升高越明显,治疗效果越明显,各组间比较,差异均有统计学意义(P均<0.05)。高峰前移组治愈率(13/29.44.8%)明显低于无高峰前移组(90/103,87.4%),差异有统计学意义(Χ^(2)=23.899,P<0.001)。三组不同甲状腺^(99)Tc^(m)显像质量分组患者治愈率比较,差异均有统计学意义(Χ^(2)=15.502,P<0.001)。结论随着甲状腺的质量增大,平均24h摄碘率越高,高峰前移越明显,其治愈率逐渐减低,未愈率增高,甲减的发生率越低。
Objective To investigate the relationship between thyroid iodine uptake rate,^(99)Tc^(m) imaging and treatment of Graves'hyperthyroidism with^(131)I.Methods 132 patients with Graves'hyperthyroidism were analyzed retrospectively.According to the difference of thyroid 24-hour iodine uptake rate,they were divided into group A(≤50%),group B(50%-80%)and group C(≥80%).According to the trend of iodine uptake rate curve,they were divided into peak advance group(6 h/24 h iodine uptake rate ratio>1)and non-peak advance group(6 h/24 h iodine uptake rate ratio=S 1).Thyroid 99 Tcm imaging was divided into three groups according to quality,including group 1(≤30 g),group 2(30-60 g)and group 3(≥60 g).The therapeutic effects of^(131)I in different types of patients were compared.Results 132 patients were followed up for 6 months after the first^(131)I treatment.The total effective rate,total cure rate and uncured rate were 88.6%(117/132),78.0%(103/132),22.0%(29/132)Respectively.The serum thyroxine levels of patients with different 24-h iodine uptake rates in the three groups after treatment were significantly lower than those before treatment(P<0.05).The lower the 24-h iodine uptake rate of thyroid,the more significantly the serum total triiodothyronine(TT3),total triiodothyronine(TT4),free triiodothyronine(FI3)and free thyroxine(FT4)levels decreased after treatment,the more obvious the increase of thyroid stimulating hormone(TSH),and the more obvious the treatment effect(P<0.05).The cure rate(13/29,44.8%)in the peak advance group was significandy lower than that in the non peak advance group(90/103,87.4%),with statistically significant difference(Χ^(2)=23.899,P<0.001).There was significant difference in the cure rate among the three groups with different thyroid ^(99)Tc^(m) imaging quality(Χ^(2)=15.502,P<0.001).Conclusions With the increase of thyroid mass,the higher the 24-h iodine intake rate,the more obvious the peak shift,the lower the cure rate,the higher the non-healing rate,and the lower the incidence of hypothyroidism.
作者
陈薏帆
朱玉春
周伟
周青
王静
杜丹
Chen Yifan;Zhu Yuchun;Zhou Wei;Zhou Qing;Wang Jing;Du Dan(Medical College of Jiangsu University,Zhenjiang 212013,China;Department of Nuclear Medicine,Kun-shan Hospital Affiliated to Jiangsu University,Kunshan 215300,China)
出处
《中国医师杂志》
CAS
2021年第10期1528-1532,1537,共6页
Journal of Chinese Physician
基金
江苏大学临床医学科技发展基金项目资助(JLY20180105)
2019昆山市重点专科培育项目(昆卫[2020]3号)。
