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摘要
Objective To analyze the correlation therapeutic effects of first sufficiency 131 I therapy in Graves' disease patients and improve its one-time curative ratio. Methods Seven hundred and sixty-six patients (age range 12-77 years, mean 40.46 +/- 13.12 years), including 237 men (range 12-77 years, 40.98 +/- 12.64 years) and 529 women (range 14-75 years, 40.22 +/- 13.34 years), who received the first 131 I treatment were studied. The relevant examinations were performed before 131 I therapy: the maximal radioactive iodine uptake of thyroid (RAIUmax), the effective half-life (EHL), the ultrasound of thyroid to calculate its weight, thyroid imaging with single-photon emission computed tomography and serum-free triiodothyronine (FT3), free thyroxine (FT4), sensitive thyroid-stimulating hormone (sTSH), anti-thyrotrophin receptor antibody (TRAb), thyroid-stimulating immunoglobulin, thyroglobulin antibody (TgAb), and antithyroid microsome antibody (TMAb). After the I-131 dosage was determined, all the patients took I-131 once orally. The I-131 dosage range was 74-592MBq (221.63 +/- 100.64 MBq). A clinical and laboratory assessment was performed at 1, 3, 6, and 12 months after I-131 therapy. Patients were divided into the clinically recovered group (symptoms and signs disappeared, free thyroid hormone levels were within or below the normal range, and sTSH was within or above the normal range) and the clinically unhealed group (symptoms and signs disappeared partially, free thyroid hormone levels were still above the normal range or within the normal range for a time and then increased again, and sTSH was constantly below the normal range). Data were analyzed by the unpaired t-test, the independent samples t-test, the chi(2) test, logistic regression, and Pearson bivariate correlation. Results The one-time curative ratio of 131 I therapy was 78.7% (including euthyroidism and hypothyroidism). Multiplicity in healing patients fit the logistic regression equation. The accuracy of discrimination of the equation was 79.5%. The influential factors of 131 I therapy were age, RAIUmax, EHL, TRAb, and TgAb. RAIUmax and EHL were the protecting factors. Age, TRAb, and TgAb were the risk factors. TRAb influenced the one-time curative ratio between patients with negative and positive TRAb, which was higher in men (2.836 times) than in women (1.438 times). Conclusion I-131 therapy is an effective intervention for Graves' disease. The higher the RAIUmax and (or) the longer the EHL, the higher the possibility of a one-time cure. Elder patients or patients with a positive TRAb and (or) TgAb have a lower possibility of a one-time cure. Women with a positive TRAb should be administered an increased I-131 dose to improve the curative effect.
- 出版日期2012-1
- 单位天津医科大学
