Watson A B, Brownlie B E, Frampton C M, Turner J G, Rogers T G
Department of Nuclear Medicine, Christchurch Hospital, Private Bag, New Zealand.
Clin Endocrinol (Oxf). 1988 May;28(5):487-96. doi: 10.1111/j.1365-2265.1988.tb03683.x.
The clinical outcome of 199 patients with Graves' disease treated with standardized 185MBq 131I therapy doses has been analysed. Most patients were controlled with antithyroid drugs prior to the 131I therapy, and also received antithyroid drugs for several months following 131I. The median follow-up period was 5.5 years. The single 185MBq 131I dose successfully treated 72.4% of patients. The 1, 2 and 5 year hypothyroid figures were 15.5%, 19.3% and 27.3%, respectively. Previous thyroidectomy was associated with an increased hypothyroid rate. Retreatment was required by 25.6%, with 3.5% requiring more than two 131I doses. Discriminant analysis of pretreatment variables suggests that patients with large goitres or severe disease (serum T3 greater than 10nmol/l) should be treated with higher doses of 131I.
分析了199例接受标准化185MBq 131I治疗剂量的格雷夫斯病患者的临床结果。大多数患者在接受131I治疗前用抗甲状腺药物控制病情,并且在131I治疗后还接受了几个月的抗甲状腺药物治疗。中位随访期为5.5年。单次185MBq 131I剂量成功治疗了72.4%的患者。1年、2年和5年的甲状腺功能减退率分别为15.5%、19.3%和27.3%。既往甲状腺切除术与甲状腺功能减退率增加有关。25.6%的患者需要再次治疗,3.5%的患者需要超过两次131I剂量。对治疗前变量的判别分析表明,甲状腺肿大较大或病情严重(血清T3大于10nmol/l)的患者应使用更高剂量的131I进行治疗。