Canadas Viviane, Vilar Lucio, Moura Eliane, Brito Ana, Castellar Enio
Serviço de Endocrinologia, Hospital das Clínicas, UFPE, Recife, PE.
Arq Bras Endocrinol Metabol. 2007 Oct;51(7):1069-76. doi: 10.1590/s0004-27302007000700008.
The treatment options for the hyperthyroidism of Graves disease are antithyroid drugs, surgery and radioiodine, none of which is considered ideal, as they do not act directly on the etiopathogenesis of the disease. Radioiodine has been increasingly used as the treatment of choice because it is a safe and definitive therapy whose administration is very easy. Some authors prefer to administer higher doses in order to deliberately induce hypothyroidism, while others recommend lower doses that result in a lower incidence of hypothyroidism and a greater incidence of euthyroidism. There is no consensus for the optimal regimen of fixed doses to be used and this is the main focus of the present study, where doses of 10 and 15 mCi of (131)I were compared. Among the 164 patients analyzed, 61 (37.2%) were submitted to 10 mCi and 103 (62.8%) to 15 mCi. In the longitudinal analysis it was observed that remission of the hyperthyroidism was statistically different in the sixth month (p < 0.001), being higher in the group that used the dose of 15 mCi, but similar in both groups at 12 and 24 months. It may be concluded that the administration of fixed doses of 10 and 15 mCi of (131)I brought about a similar remission of the hyperthyroidism after 12 months of treatment. Moreover, the remission rate of the hyperthyroidism had no association with age, sex or previous therapy with antithyroid drugs.
格雷夫斯病甲亢的治疗选择包括抗甲状腺药物、手术和放射性碘,但这些方法都不理想,因为它们并非直接作用于该疾病的发病机制。放射性碘因其安全性高、疗效确切且给药简便,越来越多地被用作首选治疗方法。一些作者倾向于给予更高剂量以刻意诱发甲状腺功能减退,而另一些人则推荐较低剂量,认为这样可降低甲状腺功能减退的发生率,提高甲状腺功能正常的发生率。对于固定剂量的最佳治疗方案尚无共识,这也是本研究的主要关注点,本研究比较了10毫居里和15毫居里的(131)I剂量。在分析的164例患者中,61例(37.2%)接受了10毫居里的治疗,103例(62.8%)接受了15毫居里的治疗。纵向分析显示,甲亢缓解情况在第6个月有统计学差异(p < 0.001),接受15毫居里剂量的组缓解率更高,但在12个月和24个月时两组相似。可以得出结论,给予固定剂量10毫居里和15毫居里的(131)I,在治疗12个月后甲亢缓解情况相似。此外,甲亢缓解率与年龄、性别或既往抗甲状腺药物治疗无关。