碘131治疗甲状腺功能亢进症效果影响因素分析

Influencing Factors of Curative Effect of Iodine 131 in Treatment of Patients With Hyperthyroidism

目的探讨影响碘131治疗甲状腺功能亢进症效果的因素。方法以某医院1990-03/2017-12行碘131治疗的1 018名甲亢患者为研究对象,收集可能的影响因素数据,对其随访1年,根据治疗效果将患者分为未愈组、治愈组和甲低组,对3组患者的数据资料进行分析,甲亢治疗影响因素使用单因素分析,多因素分析使用多项Logistic回归分析。结果单因素分析显示曾抗甲状腺药物治疗、突眼、甲状腺血管杂音、甲状腺质地、甲状腺重量、甲状腺摄碘率高峰、碘131治疗剂量和治疗次数对甲亢患者的预后有影响;多项logistic逐步回归分析显示突眼、甲状腺血管杂音、甲状腺质地、甲状腺重量、碘131治疗次数和治疗剂量对甲亢患者的预后有影响。结论甲状腺重量、治疗剂量、碘131治疗次数、甲状腺质地等因素影响碘131治疗的甲亢患者的治愈率,而存在突眼、甲状腺血管杂音降低了碘131治疗的甲亢患者出现甲低的风险,因此,在临床治疗时,应该从多因素综合考虑,为甲亢患者提供个性化的治疗方案。

Objective To explore the influencing factors of the therapeutic effects of iodine 131 on hyperthyroidism. Methods A total of 1 018 patients with hyperthyroidism treated with iodine 131 were enrolled in the study. Data of possible influencing factors were collected. Those patients were followed up for one year. Patients were divided into the unhealed group,the cured group and the hypothyroid group according to the therapeutic effect. The data of the three groups were analyzed. Results Univariate analysis showed that ATD treatment,exophthalmos, thyroid vascular murmur, thyroid texture, thyroid weight, peak thyroid iodine intake, iodine 131 therapeutic dosage and number of treatments had an effect on the prognosis of the patients. Multiple logistic stepwise regression analysis showed that exophthalmos, thyroid murmur, thyroid texture, iodine 131 treatment times and therapeutic dosage had an effect on the prognosis of the patients. Conclusion Thyroid weight,therapeutic dosage,iodine 131 treatment times and thyroid texture affect the curing rate of patients with hyperthyroidism treated with iodine 131, whereas the presence of exophthalmos and thyroid murmurs reduces the risks of hypothyroidism in patients with hyperthyroidism treated with iodine131. Therefore, personalized treatment plans for patients with hyperthyroidism should be provided from the perspective of multiple factors in clinical treatment.