小剂量^(131)I治疗甲亢的对比研究

Comparative study of low dose^(131)I treatment in patients with Graves'disease

目的:通过277例小剂量131I治疗Graves’病的临床观察资料与HowarthD的报道结果进行比较。方法:277例患者按分步法分为45Gy和77Gy两组,分别与HowarthD的60Gy和90Gy资料进行对比分析。结果:4个剂量组在治疗后6个月时,甲亢的治愈率和甲减的发生率无明显统计学差异;24月时甲功正常的比例和甲减的发生率出现高度显著的统计学差异。结论:HowarthD提出的小剂量优化治疗方案能够在减少或延迟甲减发生的前提下有效治疗Graves’病,我们认为,在此方案的基础上实行分步治疗,可以进一步降低甲减发生率,提高甲亢治愈率。

Object: To investigate the low dose 131I therapy for Graves'disease we compared the results of 277 patients in our department with the report of Howarth D et al. Methods: 277 patients were classified as 45 Gy group and 77 Gy group according to the dose level. The results of these two groups were compared sep-arately with results of 60 Gy group and 90 Gy group reported by Howarth D et al. Results: The euthyroidism rate and hypothyroidism rate among these four groups had no significant statistical difference after 6 months of 131I therapy , but there were high significant statistical difference between our study and Howarth D research about euthyroidism rate and hypothyroidism rate 24 months later. Conclusion: The low dose 131I management refered by Howarth D et al was an effective method for Graves'disease which could reduce or delay the incidence of hypothyroidism. Our study show that subsection on the foundation of this low dose procedure could further reduce the incidence of hypothyroidism and improve the euthyroidism rate.