[1]吴平,李华,易吉秀,等.2种剂量131I治疗Graves病的前瞻性随机对照研究[J].第三军医大学学报,2012,34(16):1677-1679.
 Wu Ping,Li Hua,Yi Jimei,et al.Therapeutic effect of 131-iodine at 2 different doses for Graves’ disease: a randomized controlled trial[J].J Third Mil Med Univ,2012,34(16):1677-1679.
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《第三军医大学学报》[ISSN:1000-5404/CN:51-1095/R]

卷:
34卷
期数:
2012年第16期
页码:
1677-1679
栏目:
论著
出版日期:
2012-08-30

文章信息/Info

Title:
Therapeutic effect of 131-iodine at 2 different doses for Graves’ disease: a randomized controlled trial
作者:
吴平李华易吉秀凌冰李凌陈焕梅容若慧子
重庆市黔江中心医院内分泌科
Author(s):
Wu Ping Li Hua Yi Jimei Ling Bing Li Ling Chen Huanmei Rong Ruohuizi
Department of Endocrinology, Qianjiang Central Hospital, Chongqing, 40900, China
关键词:
Graves病131I治疗剂量治疗结局
Keywords:
Graves’ disease hyperthyroidism 131I treatment dose outcome
分类号:
R581.105;R817.5
文献标志码:
A
摘要:
目的      观察2种剂量131I治疗Graves病的临床疗效、影响因素及并发症发生情况。      方法      将652例符合入选标准的Graves病患者随机分为2组,分别按照甲状腺放射性活度60~100 μCi(2.22~3.70 MBq)/g(小剂量组)、80~120 μCi(2.96~4.44 MBq)/g(常规剂量组)计算给予131I治疗剂量。随访12个月,观察2组一次性有效率及治疗后甲减发生率。8例浸润性突眼患者131I治疗后给予强的松0.5 mg/kg治疗1个月。      结果      治疗有效率:小剂量组为80.0%,常规剂量组为82%,2组比较差异无统计学意义(P>0.05)。小剂量组甲状腺功能减退发生率显著低于常规剂量组(12.1% vs 16.8%,P<0.05)。治疗结局与患者临床特征、甲状腺摄碘率、抗体水平、血浆激素水平之间均无显著相关性(P>0.05)。所有无浸润性突眼患者未发生新发眼病,8例患浸润性突眼患者眼部症状无加重。      结论      小剂量与常规剂量131I治疗甲亢一次性有效率无差别,而甲减发生率明显降低。适当调低常规治疗剂量治疗甲状腺功能亢进可能更加合理。
Abstract:
Objective      To determine the clinical therapeutic effect of 131-iodine (131I) at 2 different doses on the treatment of Graves’ hyperthyroidism, and investigate the influence factors and complications.       Methods      A randomized controlled trial was conducted on 652 Graves’ hyperthyroidism patients who were admitted in our hospital from September 2006 to June 2010. These patients were prospectively assigned into 2 matched groups, low-dose group (n=330, receiving a calculated dose of 60-100 μCi(2.22-3.70 MBq)/g 131I), and conventional dose group (n=322, receiving 80-120 μCi(2.96-4.44 MBq)/g 131I ). Patients were followed up for 12 months and considered as in remission when they were in a stable euthyroid state. Primary efficiency and incidence of hypothyroidism were compared between the 2 groups. Prednisone was given to 8 patients with infiltrative ophthalmopathy at a daily dose of 0.5 mg/kg for 1 month during radioiodine therapy.       Results      The remission rate was lower in low dose group (80.0%) than in the conventional dose group (82.9%), but no difference was found. The incidence of hypothyroidism was significantly lower in the low dose group than the conventional dose group (12.1% vs 16.8%, P<0.05). There was no correlation among clinical features, thyroid uptake, antibody levels, and serum hormones levels with outcome. For the patients having infiltrative ophthalmopathy, their symptoms did not become severer. No any new case of infiltrative ophthalmopathy was observed in the 2 group during treatment.       Conclusion      Low-dose and conventional dose have no difference in primary remission rate; but the former results in significant lower incidence of hypothyroidism. In the treatment of Graves’ hyperthyroidism with 131I, appropriately reducing conventional dose of 131I might be more reasonable for better outcome.

参考文献/References:

吴平, 李华, 易吉秀, 等. 2种剂量131I治疗Graves病的前瞻性随机对照研究[J].第三军医大学学报,2012,34(16):1677-1679.

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更新日期/Last Update: 2012-07-30