他巴唑对Graves病^(131)I治疗后碘代谢的影响

The influence of tapazole on iodine metabolism in patients with Graves' disease after ^(131)I radiotherapy

目的 观察他巴唑对Graves病 (GD)患者体内13 1I代谢的影响。方法 15 8例首次接受13 1I治疗的GD患者随机分为 3组 ,0组 6 8例 ,13 1I治疗后未服他巴唑治疗 ;Ⅰ组 5 2例 ,13 1I治疗后 2 4h开始服他巴唑 15mg/d ;Ⅱ组 38例 ,13 1I治疗后 2 4h开始服他巴唑 30mg/d。13 1I治疗后动态测定GD患者甲状腺和尿中放射性 ,观察他巴唑及其剂量对体内碘代谢的影响。结果 13 1I治疗后 3组患者不同时间甲状腺部位照射量率均呈持续下降趋势 ,但差异无显著性 (P >0 0 5 )。 3组患者尿中放射性计数均于服13 1I后 2 4h内最高 ,2 4～ 4 8h内下降 ,4 8h后 (服他巴唑 2 4h后 )Ⅰ、Ⅱ组患者均呈上升趋势 ,其发生率与 0组比较差异有显著性 (P <0 0 1)。Ⅰ组和Ⅱ组升降率比较无明显差异 (P >0 0 5 )。结论 GD患者13 1I治疗后 2 4h不宜加用抗甲状腺药物治疗 ,要依据病情适时使用。

Objective To study the influence of tapazole on 131 I metabolism in patients with Graves' disease (GD) after 131 I radiotherapy. Methods One hundred and fifty-eight GD patients of first 131 I radiotherapy were assigned to three groups. Group 0 did not receive tapazole,and group Ⅰ,Ⅱ received tapazole of different doses at 24 h after 131 I radiotherapy. The radioactive counts of patients' thyroid and urine were measured dynamically after 131 I radiotherapy and the 131 I metabolism state was estimated. Results All three groups after 131 I radiotherapy showed a continuous decreasing tendency in radioactive counts of the thyroid, but no significant difference ( P >0.05) was observed between them. Three groups' radioactive counts of urine were hightest at 24 h,and decreased at 24～48 h after 131 I radiotherapy;after 48 h (received tapazole for 24 h ) group Ⅰ,Ⅱshowed an obvious increasing tendency again,and they were significantly different from group 0 ( P <0.01),but group Ⅰ didn't show significant difference from group Ⅱ. Conclusion Antithyroid drugs (ATD) such as tapazole should not be given to GD patients strictly at 24 h after 131 I radiotherapy,but be given accordingly to the state of illness at a suitable time.