^(131)I治疗560例Graves甲亢回顾性分析

Retrospective study of 560 cases with Graves' disease treated with ^(131)I

目的探讨131I治疗Graves甲亢的效果。方法根据甲状腺质量,甲状腺最高摄131I率,每克甲状腺组织131I剂量,范围为2.59～4.44MBq,个体化,一次性空腹口服治疗560例,治疗后随访两年,并进行临床疗效评价。结果一次性131I治疗有效率为97%,痊愈率为71%,甲状腺功能减退发生率为17.5%。早发甲状腺功能减退126例(22.5%),其中一过性甲状腺功能减退38例(30.2%),晚发甲状腺功能减退10例(1.8%)。131I治疗后甲心病痊愈46例(82.1%)。131I治疗后Graves眼病好转312例(95.7%)。131I治疗后周期性麻痹痊愈22例(91.7%)。结论个体化一次性空腹口服131I治疗Graves甲亢疗效良好,131I对Graves甲亢合并眼病、甲心病、周期性麻痹治疗有效、安全。

Objective To explore the therapeutic effect of Graves＇ disease with 131I.Methods 560 fasting patients were individualized administrated 131I by oral at one time based on the weight of thyroid,the highest uptake rate of 131I and the dose of 131I administrating to per gram of thyroid.At same time,we evaluate the clinical effect after 2 years follow-up.Results All the Graves＇ disease patients,97% of them were alleviated,the curative ratio was 71%,and the incidence rate of hypothyroidism was 17.5% after the treatment with 131I.22.5%（126/560）of these patients were occurred with early hypothyroidism,30.2%（38/126） of them were transitory hypothyroidism,and 1.8%（10/126） were permanent hypothyroidism.After the 131I treatment,82.1%（46/56） Graves＇ disease patients with heart disease and 91.7%（22/24） patients with periodic paralysis caused by hyperthyroidism were cured,95.7%（321/326） patients with ophthalmopathy were alleviated.Conclusion Individual treatment to Graves disease with 131I was effective in clinical practice,as well as effective and very safe to ophthalmopathy,heart disease and periodic paralysis caused by hyperthyroidism.