Bal C S, Kumar Ajay, Pandey R M
Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India.
Thyroid. 2002 May;12(5):399-405. doi: 10.1089/105072502760043486.
To evaluate the role of lithium (Li) as an adjuvant in radioiodine therapy of hyperthyroidism.
A randomized controlled trial was carried out on 350 hyperthyroid patients with a mean follow-up period of 32.3 +/- 9.8 months (range, 12-60 months). The patients were randomized into two groups with 175 patients in each group: (1) radioiodine group (controls)-no lithium was given to these patients at any stage of their treatment and (2) radioiodine and lithium group (Li group)-lithium carbonate, 300 mg three times a day, for 3 weeks starting on the day of radioiodine administration. All patients were made euthyroid with antithyroid drugs prior to radioiodine therapy.
Mean age was 41.8 +/- 11.5 years (range, 18-71) in the control group and 41.8 +/- 12.2 years (range, 19-73) in the Li group. Mean first dose and cumulative dose of (131)I were 229 +/- 85 MBq and 326 +/- 204 MBq in controls and 233 +/- 110 MBq and 344 +/- 281 MBq in the Li group. Average number of radioiodine therapy administered was the same (1.4) in both groups. The cure rate (euthyroid plus hypothyroid) after the first dose of radioiodine in the control and the lithium groups was 68.4% and 68.9%, respectively (p = ns). The overall cure rate at the end of the study was also the same in both groups (96.7% and 96.3%, respectively). Even in patients with a rapidly discharging gland or in patients with a large goiter, no significant statistical difference was observed in radioiodine therapy outcome between the two groups. Ten percent of the patients complained of mild to moderate side effects of lithium.
The role of lithium as an adjuvant in radioiodine therapy of hyperthyroidism is insignificant.
评估锂（Li）作为辅助药物在甲状腺功能亢进症放射性碘治疗中的作用。
对350例甲状腺功能亢进症患者进行了一项随机对照试验，平均随访期为32.3±9.8个月（范围为12 - 60个月）。患者被随机分为两组，每组175例：（1）放射性碘组（对照组）——在治疗的任何阶段均未给予这些患者锂；（2）放射性碘加锂组（Li组）——从放射性碘给药当天开始，每天三次服用300 mg碳酸锂，持续3周。所有患者在放射性碘治疗前均使用抗甲状腺药物使甲状腺功能恢复正常。
对照组的平均年龄为41.8±11.5岁（范围为18 - 71岁），Li组为41.8±12.2岁（范围为19 - 73岁）。对照组（131）I的平均首次剂量和累积剂量分别为229±85 MBq和326±204 MBq，Li组为233±110 MBq和344±281 MBq。两组接受放射性碘治疗的平均次数相同（1.4次）。对照组和锂组在首次给予放射性碘后的治愈率（甲状腺功能正常加甲状腺功能减退）分别为68.4%和68.9%（p = 无显著性差异）。研究结束时两组的总体治愈率也相同（分别为96.7%和96.3%）。即使在甲状腺快速排空的患者或甲状腺肿大的患者中，两组在放射性碘治疗结果方面也未观察到显著的统计学差异。10%的患者抱怨有锂的轻度至中度副作用。
锂作为辅助药物在甲状腺功能亢进症放射性碘治疗中的作用不显著。
