影响^(131)I治疗甲状腺功能亢进症疗效的临床多因素分析

Analysis of influencing factors for therapeutic effects of ^(131)I therapy for hyperthyroidism

目的综合分析131I治疗甲状腺功能亢进症(甲亢)后疗效的影响因素。方法对接受131I治疗的164例甲亢患者进行1、3、6、12个月跟踪随访,收集其一般资料、临床资料、实验室检查和甲状腺功能检查等资料,采用二项分类Logistic回归分析法进行回顾性分析。结果多因素二项分类Logistic回归分析显示,治疗前有无突眼(F=5.171,P<0.05)、游离甲状腺素(FT4)水平(F=4.714,P<0.05)和24h最高吸131I率(F=4.314,P<0.05)是影响131I治疗效果的主要因素;对患者进行Logistic回归判别,治愈率和未愈率的准确率分别为87.8%和45.5%,总准确率为70.7%。结论 131I治疗甲亢的疗效受多种因素影响,治疗前主要根据患者有无突眼、FT4水平和24h最高吸131I率适当调整剂量;同时,采用个体化治疗,尽量考虑多种影响因素,可提高甲亢治愈率,降低治疗失败率。

Objective To analyse the influencing factors for therapeutic effects of 131I therapy for hyperthyroidism.Methods One hundred and sixty-four patients undergoing 131I therapy for hyperthyroidism were followed up for 1,3,6 and 12 months.The information of patients including general conditions,clinical findings,laboratory data and results of thyroid function tests were collected,and retrospective analysis was carried out with binary Logistic regression analysis.ResultsMulti-variate binary Logistic regression analysis revealed that exophthalmos （F=5.171,P0.05）,free thyroxine （FT4）levels （F=4.714,P0.05）and 24 h 131I uptake rate before treatment （F=4.314,P0.05）were major influencing factors for therapeutic effects of 131I therapy for hyperthyroidism.The positive and negative prediction accuracy of therapeutic effects were 87.8% and 45.5%,respectively,and the total prediction accuracy was 70.7%.Conclusion The dose of 131I administered in the therapy of hyperthyroidism depends on exophthalmos,FT4 levels and 24 h 131I uptake rate before treatment.Influencing factors should be comprehensively considered in individual therapy so as to decrease the incidence of failure and reach the optimal therapeutic effect.