^(131)I治疗青少年Graves病53例临床观察

Studies of ^(131)Iodine Therapy on Youngsters with Graves Disease(53 Cases)

目的研究^(131)I治疗青少年甲状腺机能亢进的可行性和疗效,寻找一种治疗青少年甲亢的有效方法。方法回顾性分析53例经^(131)I治疗的青少年Graves病患者,年龄14～20岁,平均16.5岁,甲状腺平均重量约为48g,其中合并Graves眼病21例,心律不齐伴心脏轻度扩大3例,并发周期性麻痹及重症肌无力7例,并发精神分裂症2例。嘱患者停用抗甲状腺药物和含碘食物至少2周,根据计算,空腹一次性口服一定剂量的^(131)I,治疗后随访观察甲状腺激素水平等至少2年以上,评价疗效。结果53例青少年Graves病患者治愈29例(54.7%),好转17例(32.0%),一过性甲低7例(13.2%)。^(131)I治疗眼病痊愈12例(57.1%),好转6例(28.6%),无效1例(4.8%)。结论^(131)I可迅速治疗Graves病,有利于青少年智力和体格发育,治疗中服^(131)I剂量应个体化,尽量减少甲低的发生率,可根治青少年Graves病。

Objective To study the feasibility and curative effect of ^131 Iodine therapy for youngsters with Graves disease. Methods Fifty-three youngsters with Graves disease were enrolled, their ages were between 14 and 20, the average quality of their thyroids was 48g. All patients were told not to take anti-thyroid drugs for 2 weeks. Then certain dose of ^131I was taken with drink. The curative effect was evaluated by observing the patients＇thyroid hormone level after ^131I-taken. Results Twenty-nine （ 54.7% ） patients were cured, 17 （ 32.0% ） were much better than before and 7 （13.2% } were temporary hypothyroid. Among 21 patients with Graves ophthalmopathy, 12（57.1% ） were cured,6（28. 6% ） were better, only 1 （4.8%） of them was invalid. Conclusion ^131I-taken can cure Graves disease much earlier than anti-thyroid drugs for youngsters. Itg beneficial to the development of youngsters＇mentality and body development. Physicians should individualize the dose of ^131I for each patient according to different condition.