[对Graves病两种不同的131I治疗方法的5年随访及影响结果的因素]。

M Yoshimoto, S Iino, H Yoshimura, N Ishikawa, N Momotani, N Hamada, K Ito
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引用次数: 2

摘要

我们对285例Graves病患者采用两种不同的131I治疗方法,并比较两种方法的治疗效果。(我们还分析了影响治疗结果的因素。)第一组180例患者接受根据患者甲状腺体重调整的单剂量131I治疗,第二组105例患者重复接受相对较低剂量的131I治疗(约30Gy)。1组5年随访显示,34%的患者甲状腺功能正常,11%的患者甲状腺功能减退,11%的患者亚临床甲状腺功能减退,44%的患者甲状腺功能亢进。2组43%的患者甲状腺功能正常,5%的患者甲状腺功能减退,35%的患者亚临床甲状腺功能减退,17%的患者甲状腺功能亢进。影响1组患者治疗结果的因素是甲状腺重量、病程和TRAb水平。131I治疗效果与患者性别、年龄、服用131I 24小时、131I有效半衰期及抗甲状腺抗体滴度无显著相关性。我们得出结论,在5年随访中,反复低剂量给予131I可提供最佳结果。然而,我们建议根据患者的甲状腺重量调整131I的剂量,以获得更快的治疗反应。
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[A five-year follow-up of two different 131I treatment methods for Graves' disease and the factors affecting the outcome].

We employed two different methods of 131I treatment for Graves' disease in 285 patients and compared the results between the two. (We also analyzed the factors affecting the treatment outcome.) A single dose of 131I adjusted to the patients' thyroid weight was administered to 180 patients in group 1, while a relatively lower dose of 131I (approximately 30Gy) was given repeatedly to 105 patients in group 2. A 5-year follow-up showed that in group 1, 34% of the patients were euthyroid, 11% hypothyroid, 11% subclinical hypothyroid and 44% still remained hyperthyroid. In group 2, 43% of the patients were euthyroid, 5% hypothyroid, 35% subclinical hypothyroid and 17% hyperthyroid. The factors affecting the outcome of the treatment in group 1 patients were their thyroid weight, the duration of the disease and TRAb levels. No significant correlation was observed between the efficacy of 131I treatment and the patients' sex, age, 24hr 131I-uptake, effective half life of administered 131I or titers of antithyroid antibodies. We conclude that the repeated low dose administration of 131I provides the best outcome in a 5-year follow-up. However, we suggest that an adjusted dose of 131I in relation to the patients' thyroid weight should be employed to obtain a faster therapeutic response.

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