Verelst J, Bonnyns M, Glinoer D
Department of Internal Medicine, University Hospital Saint-Pierre, Brussels, Belgium.
Acta Endocrinol (Copenh). 1990 Apr;122(4):417-21. doi: 10.1530/acta.0.1220417.
Large doses of radioiodine were administered since 1969 to 15 euthyroid patients with compressive voluminous goitres. A decrease in goitre size was observed in all patients (between 15 and 63%, average 39%). Maximal effect on goitre size was attained rapidly, partially already after less than one year and was almost maximal after 24 to 30 months. No significant local adverse reactions were observed; no patient required steroid administration. Hypothyroidism followed radioiodine administration in 30% of the patients after 2 years; after 8 years, all those who had survived were hypothyroid, requiring substitution therapy. In all patients there was a marked improvement in compression symptoms. The use of radioactive iodine therapy constitutes an alternative to surgery in selected patients with large compressive goitres in whom surgery is contraindicated because of age or other medical conditions.
自1969年起，对15例患有压迫性巨大甲状腺肿的甲状腺功能正常患者给予大剂量放射性碘。所有患者的甲状腺肿大小均有减小（减小幅度在15%至63%之间，平均为39%）。对甲状腺肿大小的最大效应迅速显现，部分患者在不到一年后就已出现，在24至30个月后几乎达到最大效果。未观察到明显的局部不良反应；无需对任何患者给予类固醇治疗。2年后，30%的患者在接受放射性碘治疗后出现甲状腺功能减退；8年后，所有存活患者均出现甲状腺功能减退，需要替代治疗。所有患者的压迫症状均有明显改善。对于因年龄或其他医疗状况而手术禁忌的、患有大型压迫性甲状腺肿的特定患者，放射性碘治疗可作为手术的替代方案。
