131I治疗自主功能性甲状腺结节临床分析

Clinical analysis of 131I treatment for autonomously functioning thyroid nodules

目的分析放射性131I治疗自主功能性甲状腺结节(AFTN)的临床效果。方法回顾性分析2013年4月至2019年1月在该科室接受131I治疗的22例AFTN患者资料,其中女18例、男4例,年龄(63.77±12.53)岁,所有患者均随访1年以上,对其疗效进行分析,并对其中2例特殊病例进行报道。结果22例AFTN患者经131I治疗6个月后治愈(包括甲状腺功能正常及甲状腺功能减退)21例(21/22,95.5%),其中4例(4/22,18.2%)发生甲状腺功能减退;2例特殊病例:1例为AFTN合并Graves甲状腺功能亢进(Marine-Lenhart综合征),1例131I治疗后诱发Graves甲状腺功能亢进。结论131I治疗AFTN患者安全、有效、无创;需要鉴别Marine-Lenhart综合征及预防治疗后诱发的Graves甲状腺功能亢进。

Objective To analysis the clinical effect of 131I treatment for autonomously functioning thyroid nodule(AFTN).Methods A total of 22 AFTN patients from April 2013 to January 2019 were retrospectively analyzed,18 females and 4 males with the mean age(63.77±12.53)years old.All patients were followed up for more than 1 year.The efficacy was analyzed,and 2 special cases were reported.Results After 131I therapy for 6 months,21 patients(21/22,95.5%)were cured(including euthyroid and hypothyroidism),hypothyroidism were occured in 4 patients(4/22,18.2%).There were 2 special cases:1 is coexistence of Grave disease and AFTN(Marine-Lenhart syndrome),the other is Graves hyperthyroidism induced by the treatment.Conclusion It is a safety and effective method in the treatment of AFTN with 131I.Marine-Lenhart syndrome should be identified and possible Graves hyperthyroidism induced by the treatment should be realized.