Introduction: Graves’ disease is the most common cause of hyperthyroidism. Its treatment uses synthetic antithyroid drugs but the use of aggressive radical therapy such as surgery or non-aggressive therapy such as io...Introduction: Graves’ disease is the most common cause of hyperthyroidism. Its treatment uses synthetic antithyroid drugs but the use of aggressive radical therapy such as surgery or non-aggressive therapy such as iodine-131 is not uncommon. Treatment of Graves’ disease with radioactive iodine or iratherapy is a simple, inexpensive, well-tolerated treatment. It was introduced in Senegal in 2016. We report through this work the preliminary assessment of the only nuclear medicine service in Senegal in the management of Graves’ disease by iodine-131. Patients and Methods: Retrospective study of the first cases of Graves’ disease treated with iratherapy in Senegal. Socio-demographic, clinical, paraclinical, therapeutic and evolutionary aspects were studied. Radiation protection rules have been implemented and contraception has been effective for six months in women of childbearing age. Results: 25 patients were collected with a mean age of 45 years, twenty women (80%), a family goiter in 24% and a psycho-affective context in 64% of cases. Thyrotoxicosis syndrome was associated with goiter in 68% of patients and exophthalmos in 64%. Thyroid ultrasound performed in 20 patients showed vascular goiter in 80% and thyroid scintigraphy in 3 patients, homogeneous and diffuse hyperfixation. TRAK dosed in 8 patients was still positive. All patients had received first-line medical treatment. The average duration of this treatment was more than 18 months in 92%. The empirically used iodine-131 activity averaged 15.35 mCi. Oral corticosteroid therapy was prescribed in 7 patients for the prevention of malignant orbitopathy. No early side effects were noted. The remission rate at 3 months was 52% and at 6 months was 88% to 92%. Conclusion: The effectiveness of radioactive iodine, in particular ablative doses in the treatment of hyperthyroidism, is no longer to be demonstrated. Taking into account our socioeconomic context, iratherapy should be a treatment of choice for hyperthyroidism with a good quality/price ratio and excellent tolerance.展开更多
目的:探讨I131在甲状腺机能亢进(甲亢)伴2型糖尿病患者治疗中临床效果。方法:选取84例甲亢伴2型糖尿病患者作为研究对象,分为研究组与对照组,均为42例,研究组给予I131治疗,对照组采用甲巯咪(MMI)治疗。结果:研究组治疗的总有效率为88.0...目的:探讨I131在甲状腺机能亢进(甲亢)伴2型糖尿病患者治疗中临床效果。方法:选取84例甲亢伴2型糖尿病患者作为研究对象,分为研究组与对照组,均为42例,研究组给予I131治疗,对照组采用甲巯咪(MMI)治疗。结果:研究组治疗的总有效率为88.09%,对照组的总有效率为71.43%,组间差异明显,有统计学意义(P<0.05);治疗1年后,研究组的FT3、FT4、2 h PG及Hb A1c水平均明显优于对照组,有统计学意义(P<0.05)。结论:甲亢伴2型糖尿病患者采用I131治疗,疗效显著,能有效改善患者的甲减症状。展开更多
文摘Introduction: Graves’ disease is the most common cause of hyperthyroidism. Its treatment uses synthetic antithyroid drugs but the use of aggressive radical therapy such as surgery or non-aggressive therapy such as iodine-131 is not uncommon. Treatment of Graves’ disease with radioactive iodine or iratherapy is a simple, inexpensive, well-tolerated treatment. It was introduced in Senegal in 2016. We report through this work the preliminary assessment of the only nuclear medicine service in Senegal in the management of Graves’ disease by iodine-131. Patients and Methods: Retrospective study of the first cases of Graves’ disease treated with iratherapy in Senegal. Socio-demographic, clinical, paraclinical, therapeutic and evolutionary aspects were studied. Radiation protection rules have been implemented and contraception has been effective for six months in women of childbearing age. Results: 25 patients were collected with a mean age of 45 years, twenty women (80%), a family goiter in 24% and a psycho-affective context in 64% of cases. Thyrotoxicosis syndrome was associated with goiter in 68% of patients and exophthalmos in 64%. Thyroid ultrasound performed in 20 patients showed vascular goiter in 80% and thyroid scintigraphy in 3 patients, homogeneous and diffuse hyperfixation. TRAK dosed in 8 patients was still positive. All patients had received first-line medical treatment. The average duration of this treatment was more than 18 months in 92%. The empirically used iodine-131 activity averaged 15.35 mCi. Oral corticosteroid therapy was prescribed in 7 patients for the prevention of malignant orbitopathy. No early side effects were noted. The remission rate at 3 months was 52% and at 6 months was 88% to 92%. Conclusion: The effectiveness of radioactive iodine, in particular ablative doses in the treatment of hyperthyroidism, is no longer to be demonstrated. Taking into account our socioeconomic context, iratherapy should be a treatment of choice for hyperthyroidism with a good quality/price ratio and excellent tolerance.
文摘目的:探讨I131在甲状腺机能亢进(甲亢)伴2型糖尿病患者治疗中临床效果。方法:选取84例甲亢伴2型糖尿病患者作为研究对象,分为研究组与对照组,均为42例,研究组给予I131治疗,对照组采用甲巯咪(MMI)治疗。结果:研究组治疗的总有效率为88.09%,对照组的总有效率为71.43%,组间差异明显,有统计学意义(P<0.05);治疗1年后,研究组的FT3、FT4、2 h PG及Hb A1c水平均明显优于对照组,有统计学意义(P<0.05)。结论:甲亢伴2型糖尿病患者采用I131治疗,疗效显著,能有效改善患者的甲减症状。
