改良^(131)碘给药方案治疗甲状腺功能亢进的临床效果

Clinical efficacy of modified dosage regimen of ^(131)I for treatment of hyperthyroidism

目的评估改良^(131)碘给药方案治疗甲状腺功能亢进(HH)的临床效果。方法选取HH患者66例,分为观察组和对照组各33例,均给予^(131)碘治疗。对照组患者采用常规计算剂量方案,观察组患者采用改良的计算剂量方案,其中根据不同患者的甲状腺质量和最高摄碘率,设置不同水平的1 g甲状腺计划摄^(131)碘量和给药系数,计算治疗所需^(131)碘剂量。治疗前及治疗1年后检测两组患者血清游离三碘甲状腺原氨酸(FT_3)、游离甲状腺激素(FT_4)、高敏感促甲状腺激素(hs-TSH)水平,比较两组患者的疗效及复发情况。结果治疗后,两组患者甲状腺质量均减少,FT_3和FT_4水平均下降,而hs-TSH水平均升高(P<0.05),但两组以上指标比较,差异无统计学意义(P>0.05)。两组临床治疗效果比较,差异也无统计学意义(P>0.05)。观察组甲状腺功能低下发生率、1年后复发率均低于对照组(P<0.05)。结论对于HH患者,改良^(131)碘给药方案可获得与常规给药方案相似的疗效,同时可显著降低甲状腺功能低下的发生率和1年后的复发率。

Objective To evaluate the modified dosage regimen of 1311 for the treatment of hyperthyroidism. Methods Sixty-six patients with hyperthyroidism were divided into observation group （ n = 33 ） and control group （ n = 33 ） , and were given with ~3~ I. The routine method of dosage calculation was conducted in the control group. The modified method of dosage calculation was conducted in the observation group, and the planned intake of 131I for 1 g thyroid and delivered coefficient were calculated according to the thyroid mass and maximumiodine uptake rate, then the dosage of t3t] for treatment was calculated. Before treatment and after 1 year of treatment, the serum free three iodine thyroid acid（ F＇F3 ）, free thyroid hormone（ FT4 ）, high-sensitivity thyroid stimulating hormone （TSH） of both groups were detected, the efficacy and recrudescence were compared between the two groups. Results After treatment, the thyroid mass, FT3 and FT4 levels decreased, and the TSH levels increased in both groups（ P 〈 0.05 ） , but no statistical differences in those indices above were found between the two groups （ P 〉 0.05 ）. And there was no significant difference in the clinical efficacy between the two groups （ P 〈 0.05 ）. The incidence rate of thyroid dysfunction and recurrence rate after one year of treatment in the observation group were lower than those in the control group （ P 〈 0.05 ）. Conclusion For the patients with hyperthyroidism, the modified dosage regimen of 1311 can obtain similar efficacy as the routine dosage regimen, and can effectively reduce the incidence rate of hypothyroidism and recurrence rate after one year of treatment at the same time.