病情积分法^(131)I治疗甲亢

Integration of Illness For ^(131)I Treatment of Hyperthyroidism

目的:探讨一种科学性、操作性强,可具体量化,符合个性化原则的甲亢131I治疗量的计算方法,以提高甲亢的治愈率,降低甲减的发生率。方法以:传统给药法组204例,和病情积分法96例,傅统给药法采取每克甲状腺组织平均投131I量为2545KBq(68.8KBq～3367KBq),每位对象一次服131I量为203.87MBq(62.9MBq～444MBq)。病情积分法组96例,采用以100分为基础,综合患者年龄、心率、前期治疗情况、甲状腺摄131I高峰出现时间、血清FT3、FT4、TSH、TGA、TMA含量等情况进行分数加减的“病情积分法”,计算出最后的积分数即为每克甲状腺组织的131I给予量(μCi);病情积分法平均每克甲状腺组织投131I量为4070KBq(2960KBq～7030KBq),每位病人一次服131I量平均321.16MBq(133.2～1221MBq)。结果:病情积分法治疗甲亢,一次治愈率为88.5%,比传统给药法提高了16%;早期甲减的发生率为4.2%,比传统给药法降低了0.2%。结论:该研究设计科学、合理,可操作性强,可具体量化,符合个性化原则,可明显提高甲亢的一次治愈率。

Objective:To approach into a scientific and feasible calculation of therapeutic dosage of 131 I in order to improve the cure rate of hyperthyroidism and reduce the incidence of hypothyroidism.Methods:The patients were divided into 2 groups,the first group (204 patients) were treated by conventional administration and the second group (96 patients) by integration of illness.The conventional administration included 131 I 2545 KBq (68.08 KBq^3367 KBq)in average given to one gram of thyroid tissue and 203.87 MBq (62.9 MBq^44 MBq) taken by one patient each time.On the basis of 100,integrating the age ,heart rate,previous treatment, the peak time during uptake of 131 I by thyroid and the contents of FT 3,FT 4 and TSH in sera,'the integration of illness' was worked out ,and the last integral number calcalated is the given amount of 131 I(μGi) to one gram of thyroid tissue.In the integration of illness,4070 KBq(2 960 KBq^7 030 KBq) of 131 I was given to each gram thyroid tissue and each patient took 131 I 321.16 Bq(133.2~1 221 MBq) in average each time.Results:With this treatment for hyperthyroidism,the cure rate on its first time was 88.55%,16% over conventional method of administration.Incidence of the early stage hypothyroidism was 4.2%,0.2% below that of conventional administration.Conclusion:This study is scientific,reasonable and feasible specially guantitative and in accordance with principles of characterization.It may notably improve one time cure rate of hyperthyroidism and reduce the incidence of hypothyroidism.