Graves’病^(131)I治疗剂量及甲低与TGA、TMA的关系

Relationship Between the Serum TGA,TMA Positiveness and Development of Hypothyroidism After ^(131)I Therapy in Patients with Graves' Disease

目的:从甲状腺自身免疫方面探讨G raves’病131I治疗剂量及甲低的发生因素。方法:选择131I治疗的176例G raves’病患者随访3年,分为第Ⅰ组(TGA、TMA阳性)和第Ⅱ组(TGA、TMA阴性)。采用2χ分析自身抗体水平与131I治疗剂量及甲低发生的关系。结果:Ⅰ组甲低发生率为31.4%,Ⅱ组为3.8%,Ⅰ组明显高于Ⅱ组,差异有显著性(P<0.05)。结论:TGA、TMA水平与确定131I剂量及甲低的发生关系密切。认为TGA、TMA水平高的患者应酌情减少131I用量。

Objective To study the likelibood of development of hypothyroidism after ^131Ⅰ therapy in patients with Graves＇ disease as related to the serum positiveness of TGA and TMA before treatment. Methods Altogether, 176 patients with Graves ＇ disease were treated with ^131Ⅰ and followed for 3 years of these patients, serum TGA and TMA were positive in 70 and were negative in 106. Results In the 70 patients with positive TGA and TMA, development of hypo - thyroidism after ^131Ⅰ treatment occurred in 22 subjects three years later （31.4%）. However, only 4 of the 106 patients with negative TGA and TMA developed hypothyroidism 3 years after ^131Ⅰ therapy （3.8%）. Difference in the incidence of hypothyroidism was significant （P 〈0.05）. Conclusion It is suggested that a lower dose of ^131Ⅰ be administered to patients with Graves＇ disease and positive serum TGA, TMA.