Park Se Hee, Hwang Sena, Han Seunghee, Shin Dong Yeob, Lee Eun Jig
Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul 03722, Republic of Korea.
Graduate School, Yonsei University College of Medicine, Seoul 03722, Republic of Korea.
Int J Endocrinol. 2017;2017:7354673. doi: 10.1155/2017/7354673. Epub 2017 Dec 5.
Radioactive iodine (RAI) therapy is an effective treatment option for Graves' disease. However, predicting treatment failures after RAI therapy remains controversial. The objective of this study was to investigate the factors associated with the success rate of RAI therapy for treatment of Graves' hyperthyroidism. Thyroid functional outcome, pre-RAI ultrasonographic features, and clinical parameters were evaluated retrospectively in 98 patients followed up for at least 12 months after RAI (mean RAI dose was 11.7 ± 1.8 mCi). Hypothyroidism was achieved in 59 patients (60.2%), and euthyroidism in 16 patients (16.3%), while 23 patients (23.5%) remained hyperthyroid. Age, sex, body mass index, pre-RAI thyroid function, or thyroid-stimulating immunoglobulin levels were not associated with treatment outcome. Length of thyroid isthmus ( = 0.028) and 2- to 24-hour iodine uptake ratios ( = 0.002) were significantly associated with treatment failure, which was defined as a persistent hyperthyroid status after RAI therapy. Patients with a longer isthmus had a higher risk of remaining hyperthyroid, with a threshold for isthmus length of 5.2 mm, with a sensitivity of 69.6% and specificity of 70.3% for treatment success. Measuring the length of the thyroid isthmus can be a simple and useful way to predict RAI treatment outcome.
放射性碘（RAI）治疗是Graves病的一种有效治疗选择。然而，预测RAI治疗后的治疗失败仍存在争议。本研究的目的是调查与RAI治疗Graves甲亢成功率相关的因素。对98例接受RAI治疗后至少随访12个月的患者（平均RAI剂量为11.7±1.8mCi）的甲状腺功能结局、RAI治疗前超声特征和临床参数进行回顾性评估。59例患者（60.2%）实现了甲状腺功能减退，16例患者（16.3%）实现了甲状腺功能正常，而23例患者（23.5%）仍为甲亢。年龄、性别、体重指数、RAI治疗前甲状腺功能或促甲状腺素受体抗体水平与治疗结局无关。甲状腺峡部长度（P=0.028）和2至24小时碘摄取率（P=0.002）与治疗失败显著相关，治疗失败定义为RAI治疗后持续甲亢状态。峡部较长的患者保持甲亢的风险较高，峡部长度阈值为5.2mm，对治疗成功的敏感性为69.6%，特异性为70.3%。测量甲状腺峡部长度可能是预测RAI治疗结局的一种简单而有用的方法。
