合并甲状腺结节对甲状腺功能亢进症患者131I治疗的影响研究

Influence of thyroid nodules on 131 I treatment in hyperthyroidism patients

目的 探讨甲状腺结节是否会影响放射性核素131I对甲亢的治疗效果。方法 选取2018年1月~2021年12月我科就诊的200例甲状腺功能亢进症(简称甲亢)患者作为研究对象,根据超声检查有无甲状腺结节分为两组,有结节者纳入观察组,无结节者纳入对照组。两组患者均采用放射性131I治疗,并随访6个月。比较两组患者治疗效果以及结节的大小、数量对治疗效果的影响。结果131I治疗后6个月,观察组、对照组治疗的总有效率分别为72.82%、87.04%,观察组低于对照组,差异有统计学意义(P<0.05),甲状腺结节可能降低131I对甲亢的疗效;对两组患者治疗前后的甲亢并发症进行比较发现,治疗后两组仍有部分并发症未治愈,但较治疗前例数均明显减少,两组间差异无统计学意义(P>0.05),结节并不影响甲亢并发症的治疗。将92例伴有甲状腺结节的患者根据甲状腺结节的大小、数量进行分组比较得出:结节的大小不影响131I治疗甲亢的效果(P>0.05),但是结节的数量可能影响治疗效果,结节数量越多,治愈率越低(P<0.05)。结论 甲状腺结节的大小不影响131I对甲亢的治疗效果,但是结节数量可以降低疗效,对于合并多发结节的患者可以适当增加治疗剂量。

Objective To investigate whether thyroid nodules affect the efficacy of radionuclide 131 I therapy in patients with hyperthyroidism.Methods 200 patients with hyperthyroidism who came to our department from January 2018 to December 2021 were selected as research objects.They were divided into two groups according to whether there were thyroid nodules by ultrasonography.Patients with nodules were included in the observation group and patients without nodules were included in the control group.Both groups were treated with radioactive 131 I for hyperthyroidism and followed up for 6 months.Compare the therapeutic effect of the two groups of patients and the influence of the size and number of nodules on the therapeutic effect.Results Six months after 131 I treatment,the total effective rates of the observation group and the control group were 72.82%and 87.04%respectively.The observation group was lower than the control group,the difference was statistically significant(P<0.05),the thyroid nodules can reduce the curative effect of 131 I on hyperthyroidism;by analyzing the complications of hyperthyroidism before and after treatment,it was found that after treatment some complications of hyperthyroidism patients in both groups were still not cured,but the number of patients of the cases was significantly reduced compared with that before treatment,the difference was not statistically significant(P>0.05),nodules do not affect the treatment of hyperthyroidism complication.In addition,92 patients with thyroid nodules were divided into groups according to the size and number of thyroid nodules.It was concluded that the size of the nodules did not affect the effect of 131 I on hyperthyroidism(P>0.05),but the number of nodules could affect the effect of treatment.The more nodules,the lower the cure rate(P<0.05).Conclusion The size of thyroid nodule will not affect the therapeutic effect of 131 I on hyperthyroidism,but the number of nodules can reduce the efficacy,for patients with multiple nodules,the therapeutic dose can be appropriately increased.