^(131)I治疗儿童及青年格雷夫斯病疗效及影响因素分析

Efficacy and affecting factors in ^(131)I therapy for children and young people with Graves’disease

目的探讨^(131)I治疗儿童及青年格雷夫斯病(GD)的疗效及其影响因素。方法回顾性分析2013年—2022年在简阳市人民医院核医学科院接受^(131)I治疗且年龄≤22岁的儿童及青年GD患者的临床资料。采用个体计算剂量法,每克甲状腺组织的计划用量为80~140μCi,依据甲状腺吸碘率及甲状腺质量,确定^(131)I的用量。依据^(131)I治疗后3~6个月的甲状腺功能指标,进行疗效评价,甲状腺功能恢复正常或发生甲减视为治愈。统计分析治愈组与非治愈组间的临床疾病特征参数,评估可能影响疗效的因素。结果纳入患者71例:男23例、女48例,年龄11~22岁。患儿甲状腺质量4.8~60.0 g,均值22.1 g。^(131)I的用量在6~24 mCi,均值11.3 mCi。49例(69%)患者获得治愈,22例(31%)未获治愈。单因素分析显示年龄、性别、促甲状腺激素受体抗体的滴度、甲状腺吸碘率、甲状腺质量及^(131)I用量等,治愈组与非治愈组间比较差异均无统计学意义(均P>0.05)。结论以每克甲状腺组织80~140μCi的计划用量,确定^(131)I用量治疗儿童青年GD的疗效可达69%。

Objective To investigate the effect of ^(131)I on Graves’disease(GD)in children and young adults and its influencing factors.Methods The clinical data of GD patients aged≤22 who received ^(131)I treatment in Nuclear Medicine Department of Jianyang People’s Hospital from 2013 to 2022 were retrospectively analyzed.The planned dosage of ^(131)I was 80~140μCi per gram of thyroid tissue,and the dosage of ^(131)I was determined according to the iodine uptake rate and thyroid mass.According to the thyroid function indicators of 3 to 6 months after ^(131)I treatment,the curative effect was evaluated,and the thyroid function returned to normal or hypothyroidism occurred were considered as cured.The clinical characteristic parameters of the cured group and the noncured group were analyzed to evaluate the factors that might affect the curative effect.Results Seventy-one patients were included:23 males and 48 females,aged 11-22.The thyroid mass of the children ranged from 4.8 to 60.0 g,with an average of 22.1 g.The dosage of ^(131)I ranges from 6 to 24 mCi,with an average of 11.3 mCi.Forty-nine patients(69%)were cured and 22(31%)were not cured.Univariate analysis showed that there were no significant differences in age,sex,titer of thyrotropin receptor antibody,thyroid iodine uptake rate,thyroid mass and ^(131)I dosage between the cured group and the non-cured group(all P>0.05).Conclusions With the planned dosage of 80~140μCi per gram of thyroid tissue,the efficacy of ^(131)I in the treatment of GD in children and young adults can reach 69%.