影响^(131)I治疗Graves病疗效的多因素分析

Multivariate Analysis of Therapeutic Effect of ^(131)I Treatment on Graves′ Disease

目的探讨影响131I治疗Graves病疗效的因素。方法对172例首次接受131I治疗的Graves病患者随访1年,根据疗效分为痊愈组、未愈组和甲状腺功能减退(甲减)组,分析患者的年龄、性别、甲状腺重量、病程、治疗前是否用过抗甲状腺药物(ATD)、甲状腺最高摄131I率、甲状腺球蛋白抗体(TGA)和甲状腺微粒体抗体(TMA)等因素与疗效的关系。并分级量化每个指标,进行多因素logistic分析。结果 logistic逐步回归分析显示甲状腺重量、甲状腺最高摄131I率、TGA、TMA对疗效有影响(P<0.05)。结论131I治疗Graves病疗效与甲状腺重量、甲状腺最高摄131I率、TGA、TMA等因素有关,治疗时适当考虑这些因素有一定的临床意义。

Objective To study the influencing factors of therapeutic effect of 131I treatment on Graves＇ disease. Methods One hundred and seventy-two patients with Graves＇ disease who were followed up for one year after receiving the first 131I trentment were divided into three groups ：cured group ,uncured group and hypothyroidism group. To analyze the relationship between the therapeutic effect and the factors including age, gender, thyroid weight, disease course, taking antithyriod drug（ATD） before treatment or not, the highest thyroid uptake ratio of 131I, thyroglobulin antibody（TGA） and thyroid mitochondria antibody （TMA）. Multiple logistic regression analysis was performed. Results Logistic stepwise regression analysis suggested that the thyroid weight,the highest thyroid uptake ratio of 131I,TGA and TMA were significantly associated with the effectiveness（P 〈 0.05）. Conclusion The effectiveness of 131I on the treatment of Graves＇ disease is associated with the thyroid weight, the highest thyroid uptake ratio of 131I, TGA, TMA and so on. These factors might be significant for the clinical practice.