^(131)I治疗Graves病早期疗效及影响因素分析

Analysis on the early curative effect and influencing factors of ^(131)I for patients with Graves disease

目的:探讨^(131)I治疗Graves病的早期疗效及影响因素分析。方法:选取2015年1月~2017年3月82例^(131)I治疗Graves病患者的临床资料进行分析,男性22例,女性60例,年龄(43.9±13.4)岁,治疗6个月后进行疗效随访。分析计划量、甲状腺平均质量、病程、停抗甲状腺药物(ATD)时间对疗效的影响,治疗效果分为有效、无效。采用t检验、卡方检验及多元Logistic回归模型分析。结果:^(131)I治疗的有效率为69.5%(57/82),无效率为30.5%(25/82)。不同疗效组计划量、甲状腺平均质量、病程、停ATD时间差异有统计学意义(t=2.165、3.524、3.173,χ2=7.577,P均<0.05)。多元Logistic回归模型分析表明计划量(Wald=4.438,P=0.035)和平均质量(Wald=3.964,P=0.041)是影响疗效的重要因素。结论:^(131)I治疗Graves病早期疗效较好,计划量、甲状腺平均质量、病程、停药时间是影响疗效的主要因素。

Objective： To assess the early efficacy and influencing factors of （131）I in the treatment of patients with Graves disease. Methods： The clinical data were retrospectively analyzed in 82 cases of Graves disease[22 males,60 females; age：（ 43. 9 ± 13） 4 years]undergone （131）I treatment in our hospital between January 2015 and March 2017. All patients received follow-up six months after treatment. Data analysis included the effects of planned dosage,average weight of thyroid gland,course of disease and the time to withdraw antithyroid drug（ ATD） on the curative outcomes. Therapeutic effects were defined as effectiveness and ineffectiveness,and analyzed with student＇s t-test,chi-square test and binary Logistic regression model. Results： 69. 5%（ 57/82） of the patients responded well to （131）I treatment,and 30. 5%（ 25/82） failed. The difference was significant among groups with different therapeutic efficacies concerning diverse planned dosage,average weight of thyroid gland,course of disease and time of withdrawing ATD（ t = 2. 165,3. 524 and 3. 173,respectively; χ2= 7. 577,all P〈 0. 05）. Analysis by the binary Logistic regression model indicated that the planned dosage（ Wald = 4. 438,P = 0. 035） and the average weight（ Wald = 3. 964,P = 0. 041） were the important factors affecting the curative outcomes. Conclusion： （131）I has early curative efficacy in the treatment of patients with Graves disease. Primary factors affecting the treatment outcomes include planned dosage,average weight of thyroid gland,course of disease and the time to withdraw ATD.