^(131)I注射治疗Plummer’s病患者的临床研究

Clinical Study on the Treatment of Patients with Plummer’sDisease with Intranodular Injection of 131 I

目的:研究探讨131I注射治疗Plummer’s病患者的临床应用价值。方法:36例Plummer’s病患者采 用131I直接注射到自主功能性甲状腺结节(AFTN)的中心部位,治疗前、后疾病组和32例对照组均检测T3、T4、 TSH(采用ACCESS微粒子化学发光免疫分析法)含量;测定AFTN及外周血液Hb及各类细胞(采用COULTER 三分类法)治疗前、后的变化。结果:应用131I注射治疗Plummer’s病患者疗效显著(P<0.001),对外周血液 Hb及各类细胞均无明显影响(P>0.05),1年左右AFTN消失,随访三年甲亢未见复发,没有发现甲减、甲癌及 血液方面等病例。结论:应用131I注射治疗Plummer’s病患者具有临床应用价值,小剂量核素可达到治疗效果, 毒副反应小,是一项行之有效的新治疗方法。

Objective To study the clinical applicability of intranodular injection of 131 I for the treatment of patients with Plummer’s disease. Methods Direct injection of a calculated amount of (1mCi/1ml vol) into the autonomous functioning thyroid nodule (AFTN) was performed in 36 patients with Plummer’s disease. Serum levels of the thyroid hormones (T 3, T 4, TSH) were measured in the patients before and six months after treatment as well as in 32 controls. peripheral blood pictures were examined with COULTER three assortements every six months for three years. Results The treatment was very successful in all of the patients. They became euthyroid regularly (thyroid hormones levels at six months after treatment vs before treatment P<0.01, vs controls P>0.05). Peripheral blood pictures were not much changed (vs before treatment and controls P>0.05). The AFTNs usually disappeared at one year with only two exceptions which were surgically removed. No relapse of hyperthyroidism or hypothyroidism occurred at 3years after treatment. Conclusion Treatment of Plummer’s disease with intranodular injection of 131 I is clinically practical. Only a small dose of drug (3~6mCi, about one tenth to one fifth of the conventional systemic oral dose) is therapeaticly adequate, with little side-effects. Also, hypothyroidism has not been encountered.