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目的 探讨停用复方碘溶液不同时间对格雷夫斯病(GD)患者摄131Ⅰ功能及131Ⅰ疗效的影响.方法 回顾性纳入2012年1月至2016年11月首次接受131Ⅰ治疗GD的患者1 585例(男415例,女1 170例;年龄17～ 62岁),分为预治疗组(131Ⅰ治疗前服用过复方碘溶液)85例[停用复方碘溶液4～7d组(A组)35例,停用8～14d组(B组)28例,停用15～ 30 d组(C组)22例]和对照组(未服用复方碘溶液)1 500例.比较4组患者的最高摄131Ⅰ率(RAIU)、有效半衰期、131 Ⅰ治疗前的游离三碘甲状腺原氨酸(FT3)和游离甲状腺素(FT4)水平,并进行疗效评价.采用单因素方差分析、Ridit分析和x2检验分析数据.结果 A～C组与对照组最高RAIU分别为(64.86±13.20)％、(67.40±9.10)％、(73.46±4.65)％和(74.14±9.87)％,差异无统计学意义(F=1.658,P＞0.05).4组有效半衰期差异亦无统计学意义(F=0.651,P＞0.05).A～C组与对照组患者的FT3水平分别为(11.90±4.85)、(15.51±2.95)、(22.08±2.31)和(23.98±4.98) pmol/L(F=13.972,P＜0.01),其中A组与B组明显低于对照组及C组(t值:6.57 ～12.08,均P＜0.05);上述4组FT4水平分别为(25.65±11.95)、(32.33±6.25)、(68.41± 13.94)和(73.65±21.55)pmol/L(F=21.238,P＜0.01),A组与B组FT4水平明显低于对照组及C组(t值:36.09～48.00,均P＜0.01).预治疗组与对照组患者总体疗效比较差异无统计学意义(u=0.397,P＞0.05);4组间完全缓解率差异亦未见统计学意义(x2=1.169,P＞0.05).结论 131Ⅰ治疗GD前使用复方碘溶液行预治疗,停药后2周内行131Ⅰ治疗;为避免131Ⅰ治疗后出现甲亢加重,建议停用4～7d即可行131Ⅰ治疗.“,”Objective To investigate the influence of different time discontinuation of compound iodine solution on 131Ⅰ uptake and curative effect of 131Ⅰ therapy in patients with Graves disease (GD).Methods A total of 1 585 patients (415 males,1 170 females;age range:17-62 years) treated with 131Ⅰ therapy for the first time between January 2012 and November 2016 were enrolled in this retrospective study.All patients were divided into preliminary treatment group (n =85) and control group (no iodine solution taking,n =1 500).Preliminary treatment group including 4-7 d discontinuation subgroup (group A,n=35),8-14 d discontinuation subgroup (group B,n=28) and 15-30 d discontinuation subgroup (group C,n=22).The high-est radioactive iodine uptake (RAIU),effective half-life,free triiodothyronine (FT3) and free thyroxine (FT4) levels before 131Ⅰ therapy were compared,and curative effects were evaluated.One-way analysis of variance,Ridit analysis and x2 test were used to analyze the data.Results The highest RAIU in group A,group B,group C and control group was (64.86 ± 13.20) ％,(67.40 ± 9.10) ％,(73.46 ± 4.65) ％ and (74.14±9.87) ％,respectively (F =1.658,P＞ 0.05).No significant difference was found in the effective half-life among 4 groups (F=0.651,P＞0.05).FT3 level in group A and group B ((11.90±4.85) and (15.51±2.95) pmol/L) was significantly lower than that in control group ((23.98±4.98) pmoL/L) and group C ((22.08±2.31) pmol/L;F=13.972,t values:6.57-12.08,all P＜0.05).FT4 level in group A and group B ((25.65±11.95) and (32.33±6.25) pmol/L) was obviously lower than that in control group ((73.65±21.55) pmol/L) and group C ((68.41±13.94) pmo]/L;F=21.238,t values:36.09-48.00,all P＜0.01).The overall curative effect of preliminary treatment group and that of control group were not statistically significant (u=0.397,P＞0.05),and no significant difference was found in the complete remission rates among 4 groups (x2 =1.169,P＞0.05).Conclusions If pretreatment with compound iodine solution is used before 131Ⅰ therapy in GD,it is feasible to carry out 131Ⅰ therapy within 2 weeks after withdrawal.In order to avoid the possibility of severe hyperthyroidism after 131Ⅰ therapy,it is recommended that radioiodine treatment should be carried out after discontinuation for 4-7 d.