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目的:对131I治疗Graves甲亢的临床疗效进行观察,对治疗结果展开分析,并就其与疗效影响因素两者的关系作出探讨。方法:取2012年6月～2012年11月在院治疗的120例Graves甲亢患者作为研究对象,每克甲状腺组织计划剂量为4.4MBq.通过下列公式计算每例患者所服的剂量:剂量(MBq)=[计划剂量MBq/g甲状腺组织×甲状腺重量]/24小时吸碘率%。并在3～6月内进行随访。治疗结果依次为:甲状腺功能恢复至正常水平、甲状腺功能降低、持续性甲亢状态。结果:在120例Graves患者中,甲状腺功能正常为42例(36.8%);甲状腺功能发生减退者62例(47.4%),持续甲亢状态患者为16例(13.3%),持续甲亢状态的患者的症状有不同程度的减轻。治愈总有效率为84.2%(功能正常+甲状腺功能减退)。采用统计学对其进行分析发现,甲状腺质量、甲状腺组织吸收放射性活度/克与治疗结果之间具有统计学意义(F=17.638,P=0.000;F=28.452,P=0.000);治疗结果与患者的甲状腺吸碘率和患者年龄之间不具有统计学意义(F=1.374,P=0.265;F=2.452,P=0.100)。结论:131I个体计算计量法(每克甲状腺组织计划剂量为4.4MBq).对治疗甲状腺功能亢进较为有效,使其能够快速恢复正常,保证治疗效果的同时,尽量减少早期甲减的发生率。
OBJECTIVE: To observe the clinical effect of 131I on Graves’ hyperthyroidism, analyze the results of the treatment, and discuss the relationship between 131I and the influencing factors. METHODS: A total of 120 Graves hyperthyroidism patients treated in our hospital from June 2012 to November 2012 were enrolled in a planned dose of 4.4 MBq per gram of thyroid tissue. The dose for each patient was calculated by the following formula: Dose (MBq ) = [Planned dose MBq / g thyroid tissue x thyroid weight] /% iodine uptake in 24 hours. And in 3 to 6 months for follow-up. The treatment results were as follows: thyroid function returned to normal levels, hypothyroidism, persistent hyperthyroidism. Results: Of the 120 patients with Graves, 42 (36.8%) had normal thyroid function, 62 (47.4%) had hypothyroidism, 16 (13.3%) had persistent hyperthyroidism, Symptoms have varying degrees of relief. The total effective rate of cure was 84.2% (normal function + hypothyroidism). Statistical analysis showed that there was a significant difference between the thyroid mass, thyroid tissue radioactivity absorption / g and the treatment outcome (F = 17.638, P = 0.000; F = 28.452, P = 0.000) The thyroid iodine uptake rate in patients was not statistically significant with patient age (F = 1.374, P = 0.265; F = 2.452, P = 0.100). Conclusion: The 131I individual calculation method (the planned dose of thyroid gland is 4.4MBq per gram) is more effective in the treatment of hyperthyroidism, which can quickly return to normal, to ensure the therapeutic effect, while minimizing the incidence of early hypothyroidism.