Eschmann S M, Thelen M H, Dittmann H, Bares R
University of Tuebingen, Department of Nuclear Medicine, Germany.
Exp Clin Endocrinol Diabetes. 2006 May;114(5):222-6. doi: 10.1055/s-2006-924238.
The factors influencing success of treating Graves' disease with radioiodine ( (131)I) are discussed controversially. This study analyses prospectively the influence of discontinuing antithyroid drugs (ATD) immediately prior to treatment with radioiodine on the therapeutic outcome.
We studied 141 patients with Graves' disease. In 73 of them (group A) treatment was performed under medication with ATD, in 68 patients (group B) ATD were discontinued for 3 - 7 days starting at the time of therapy. We performed a statistical analysis of the influence of ATD and other factors potentially influencing treatment results.
In group A 49/73 patients were treated successfully (67 %) vs. 58/68 (85 %) in group B (p < 0.01). Characteristic changes in the kinetics of radioiodine were observed: after discontinuing ATD specific uptake was higher (2.0 %/ml in group A vs. 2.6 %/ml in group B, p = 0.004), and the effective half life was longer (5.1 +/- 1.3 d in group A vs. 5.5 +/- 1.1 d in group B, p = 0.076) resulting in a significantly higher radiation dose in group B (200 +/- 61 Gy in group A vs. 236 +/- 72 Gy in group B, p = 0.002).
We conclude that short-term interruption of ATD improves the success rate of treating Graves' disease with radioiodine significantly.
关于影响放射性碘（¹³¹I）治疗格雷夫斯病成功的因素存在争议性讨论。本研究前瞻性分析了在放射性碘治疗前立即停用抗甲状腺药物（ATD）对治疗结果的影响。
我们研究了141例格雷夫斯病患者。其中73例（A组）在服用ATD的情况下进行治疗，68例患者（B组）从治疗开始时起停用ATD 3 - 7天。我们对ATD以及其他可能影响治疗结果的因素的影响进行了统计分析。
A组73例患者中有49例（67%）治疗成功，而B组68例中有58例（85%）治疗成功（p < 0.01）。观察到放射性碘动力学的特征性变化：停用ATD后，特异性摄取更高（A组为2.0%/ml，B组为2.6%/ml，p = 0.004），有效半衰期更长（A组为5.1±1.3天，B组为5.5±1.1天，p = 0.076），导致B组的辐射剂量显著更高（A组为200±61 Gy，B组为236±72 Gy，p = 0.002）。
我们得出结论，短期中断ATD可显著提高放射性碘治疗格雷夫斯病的成功率。
