不同剂量^(131)I治疗甲状腺功能亢进症的临床效果比较

Clinical comparison of different dosage of ~131I in the treatment of hyperthyroidism

目的观察不同剂量131I在治疗甲状腺功能亢进症中的临床效果。方法选取2010年1月~2013年11月在本院就诊的64例弥漫性甲状腺肿伴甲亢患者为研究对象,将其随机分为小剂量组和常规剂量组,各32例。小剂量组给予50~80μCi/g甲状腺组织的131I,多次重复使用;常规剂量组一次性口服100~120μCi/g甲状腺组织的131I。比较两组患者治疗前后血清FT3、FT4、TSH水平、临床疗效及甲减发生率。结果治疗前,两组血清FT3、FT4、TSH水平均未见显著性差异(P>0.05);治疗后,两组FT3、FT4水平较治疗前显著下降,TSH较治疗前显著上升,前后差异有统计学意义(P<0.05),但治疗后两组的三项指标水平无显著性差异(P>0.05)。小剂量组的治疗有效率为96.9%,常规剂量组为100.0%,两组的治疗有效率未见显著性差异(P>0.05)。治疗1年后,小剂量组甲减发生率为3.1%,常规剂量组为18.8%,小剂量组的甲减发生率低于常规剂量组,差异有显著性(P<0.05)。结论采用小剂量131I治疗甲状腺功能亢进症的临床疗效好、甲减发生率低。

Objective To observe the clinical effects of different dosage of131 I in the treatment of hyperthyroidism.Methods 64 patients with diffuse goiter associated with hyperthyroidism treated in our hospital from January 2010 to November 2013 were selected and randomly divided into small-dose group and standard-dose group,32 cases in each group.Small-dose group was given 50 to 80 μCi/g thyroid tissue131 I,repeated use.Standard-dose group was taken 100 to120 μCi/g thyroid tissue131 I in the conventional dose group by once orally.The levels of FT3,FT4 and TSH as well as clinical efficacy and incidence of hypothyroidism in two groups before and after treatment were compared. Results Before treatment,the levels of FT3, FT4 and TSH of two groups were not significantly different（P0.05）.After treatment,the levels of FT3 and FT4of two groups were significantly lower than before,and the level of TSH was significantly higher than before（P0.05）,the differences was significant before and after treatment（P0.05）,but the level of three indicators in two groups were not significantly differents（P0.05）.The effective rate of treatment in small-dose group was 96.9%,in standard-dose group was 100.0%,the difference was not significant between two groups（P0.05）.After 1 year of treatment,the incidence of hypothyroidism insmall-dose group was 3.1%,which was lower than 18.8% of standard-dose group,the difference was significant（P0.05）. Conclusion The small dosage of131 I has a good clinical effect in the hyperthyroidism and reduces the incidence of hypothyroidism.