DeGroot L J, Mangklabruks A, McCormick M
Department of Medicine, University of Chicago, IL 60637.
J Endocrinol Invest. 1990 Feb;13(2):111-8. doi: 10.1007/BF03349519.
The efficacy of 131I therapy in achieving euthyroidism has been studied in a group of 264 patients followed for up to 10 yr. One hundred and eighty-six were given a dose adjusted for thyroid size and radioactive iodine uptake (Protocol 1), and a second group received the same dosage followed by antithyroid drug therapy plus potassium iodide for 15 days (Protocol 2). At 10-yr follow-up, 50-60% of patients were euthyroid. 25-29% of patients required 2 doses of 131I, and 4-5% required 3 doses. Fewer patients became hypothyroid when their pretreatment FTI was above the average value. More patients became hypothyroid, if their pretreatment test for antimicrosomal antibodies was positive. Patients who required a second dose of radioactive iodide had a significantly greater chance of having worsening of their ophthalmopathy than those who became hypothyroid after the first dose. Treatment with radioactive iodide under either protocol appears to achieve euthyroidism at 10 yr with an incidence higher than that achieved by antithyroid drugs and comparable to that reported for subtotal thyroidectomy.
对一组264例患者进行了长达10年的随访，研究了131I治疗实现甲状腺功能正常的疗效。186例患者根据甲状腺大小和放射性碘摄取量调整剂量（方案1），另一组接受相同剂量治疗，随后接受抗甲状腺药物治疗加碘化钾治疗15天（方案2）。在10年的随访中，50%-60%的患者甲状腺功能正常。25%-29%的患者需要2剂131I，4%-5%的患者需要3剂。治疗前FTI高于平均值的患者发生甲状腺功能减退的较少。如果治疗前抗微粒体抗体检测呈阳性，则更多患者会发生甲状腺功能减退。需要第二剂放射性碘的患者比第一剂后发生甲状腺功能减退的患者发生眼病恶化的可能性显著更高。两种方案下用放射性碘治疗在10年时似乎都能实现甲状腺功能正常，其发生率高于抗甲状腺药物治疗，与甲状腺次全切除术报告的发生率相当。
