分化型甲状腺癌碘-131初始治疗后早期不良反应影响因素分析

Analysis of Influencing Factors of Early Adverse Reactions after Initial Treatment of Iodine-131 in Differentiated Thyroid Cancer

目的分析分化型甲状腺癌(DTC)术后,初次行碘-131治疗后患者的早期不良反应及其影响因素。方法选择2022年1月—2022年12月间于赤峰市医院核医学科核素治疗病房因DTC术后初次行碘-131治疗的患者106例作为研究对象,记录患者口服碘-131后4 d内的早期不良反应发生情况,采用Logistic回归分析的方法分析其影响因素。结果106例患者中发生颈部肿胀或疼痛41例,胃部不适或呕吐36例,口干或口腔溃疡32例,味觉异常11例,眼干10例,胸闷、气短3例。这些不良反应的发生与吸碘率、碘-131用量、抗甲状腺球蛋白抗体(TgAb)值、术后分期等多种因素相关。颈部疼痛、肿胀与其影响因素的多因素回归方程为Y=2.223×4 h吸碘率+20.802×术后分期-28.689,方程的预测符合率86.8%。总体不良反应的多因素回归方程为Y=0.084×服碘量+0.597×24 h吸碘率-11.499。方程的预测符合率为82.1%。结论DTC患者碘-131治疗后早期不良反应有部分明确的影响因素,可以进行早期药物或护理干预,减少早期不良反应的发生。

Objective To analyze the early adverse reactions of patients with diff erentiated thyroid cancer(DTC)after initial iodine-131 treatment and its infl uencing factors.Methods 106 patients who were treated with iodine-131 for the fi rst time after DTC surgery in the nuclide treatment ward of Chifeng Municipal Hospital from January 2022 to December 2022 were retrospectively collected.Adverse reactions within 4 days after taking oral iodine-131 were recorded,and the influencing factors were analyzed by Logistic regression analysis.Results Among the 106 patients,41 had neck swelling or pain,36 had stomach discomfort or vomit,32 had dry mouth or canker sores,11 had abnormal taste,10 had dry eyes,and 3 had chest tightness and shortness of breath.These adverse reactions were related to iodine absorption rate,iodine-131 dosage,TgAb level,postoperative stage and other multi-factors.The multiple factor regression equation of neck pain and swelling and its infl uencing factors was y=2.223×4h iodine uptake rate+20.802×postoperative staging-28.689.The predictive accuracy of the equation was 86.8%.The multiple factor regression equation of the total adverse reaction was y=0.084×iodine dosage+0.597×24h iodine uptake rate-11.499.The predictive accuracy of the equation was 82.1%.Conclusion Early adverse reactions of DTC patients after iodine-131 treatment have some clear infl uencing factors,and early drug or nursing intervention can be carried out to reduce the occurrence of early adverse reactions.