^(131)I治疗甲状腺机能亢进症的230例疗效分析

Therapeutic Effect of ^(131)I for 230 Patients with Hyperthyroidism

随访观察131I治疗甲亢的疗效,分析影响因素。230例甲亢患者服用131I,每例患者均于治疗后1.5、3、6、12个月或者更长时间随访,均复查FT3、FT4及TSH。结果显示,临床治愈181例(78.6%),好转22例(9.5%),早发甲减23例(10.0%),迟发甲减4例(1.7%)。所有甲减患者均用甲状腺素替代治疗,其中12例恢复正常,另15例需要终身替代治疗。结论:根据患者年龄、病程、ATD应用情况、甲状腺大小及形状、甲状腺激素水平等因素决定治疗剂量。治疗后需密切随访观察,警惕甲减的发生。对早发甲减应及时替代治疗,降低永久性甲减的发生率。

To evaluate the therapeutic effect of 131I in treatment of patients with hyperthyroidism and analysis the factors that influence the effect, 230 cases of hyperthyroidism were treated with 131 I, and were followed-up at 1. 5, 3, 6, 12 months and even longer time after 131I radiotherapy. The serum levels of FT3, FT4 and TSH were detected in all cases. The results showed that 181 patients were cured （78.6%）, 22 patients were improved （9.5%）, 23 cases developed early hypothyroidism （10.0%）, and 4 cases developed later hypothyroidism. 12 cases in 27 patients with hypothyroidism treated with thyroxin were recovered, but the other 15 cases need to be given permanent treatment. The factors which influence 131I radiotherapeutic effect include the patient age, course of disease, application of ATD, size and quality of thyroid, and the level of thyroid hormone. The patients should be followed up to prevent occurrence of hypothyroidism. The early hypothyroidism should be treated in order to decrease the permanent hypothyroidism rate.