甲状腺VITU预测^(131)I治疗甲亢的疗效

Predictive value of the visual index of thyroid uptake(VITU) for hyperthyroidism after^(131)I therapy

目的 :探讨测定甲状腺指数(VITU)对预测131I治疗甲亢的疗效。材料与方法 :用99mTcO作甲状腺γ照相 ,测定并随访了113例甲亢患者131I治疗后及126例正常人对照组的甲状腺摄取99mTc的VITU ,并与FT3、FT4 进行比较。结果 :甲亢131I治疗后治愈组VITU与未治组、治后部分缓解组或无效组比较均有非常显著性差异(P<0 01) ,与正常人组比较无显著性差异 ;其VITU值分别为未治组16 58±7 52 ,治愈组3 86±1 95 ,部分缓解组15 72±5 42 ,无效组20 17±7 60 ,正常人组3 53±1 70。若以未治组VITU均值减一个标准差(x-s)即9 06作判别阈 ,则VITU诊断131I治疗是否治愈和预测是否复发的符合率高于FT3、FT4,分别为94 9 %、95 1 %。诊断甲亢131I治疗治愈的灵敏度、特异性和准确性分别为93 2 %、96 7 %、95 2 %。结论 :甲亢患者131I治疗后定期复查VITU值 ,对确定是否治愈或预测是否复发进而采取适当的治疗措施方面有其重要价值。

Objective:To assess the predictive value of the visual index of thyroid uptake(VITU)in patient of hyperthyroidism after131I therapy.Methods:Took the imaging of thyroid with 99mTcO ,the VITU was measured in this study in 113 patients of hyperthyroidism after 131I therapy and 126 normal subjects.Results:There was significant difference between the VITU of the cure group and the untreated group,partial remission group and treatment failure group,but no significant difference compared with the control group.The VITU values for the groups of untreatment were 16.58±7.52,for the groups of cure were 3.86±1.95,for the groups of remission were 15.72±5.42,for the groups of no effect were 20.17±7.60,and for the normal subjects were 3.53±1.70.If the threshold for cure was set at the mean of untreated hyperthyroid minus 1 SD,namely 9.06,VITU was the best index both for cure and predict of relapse as compared with FT3,FT4,confirmation rates being 94.9% and 95.1% respectively. The sensitivity was 93.2%, the specificity 96.7%, and accuracy 95.2%.Conclusions:There was very significant value to recheck VITU for the patient of hyperthyroidism after 131I therapy periodically with respect to either confirmation of cure or prediction of relapse in order to take proper further treatment.