Department of Traditional Chinese Medicine, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China.
Department of Endocrinology, Hospital of Traditional Chinese Medicine of Linyi City, Linyi, 276002, Shandong, China.
BMC Endocr Disord. 2020 May 29;20(1):76. doi: 10.1186/s12902-020-00557-w.
Radioactive iodine (RAI) therapy is an important treatment option for Graves' disease (GD), the main side effect of RAI treatment is hypothyroidism, and the factors resulting in hypothyroidism are still controversial. The purpose of this retrospective study was to clarify the possible risk factors of early hypothyroidism after RAI therapy in Graves' disease.
We reviewed 312 GD patients treated with RAI between January 2017 to December 2018, collected the potential risk factors, and analyzed the relationship between these variables and early hypothyroidism.
After 6 months' follow-up, 218 (69.87%) patients were evaluated as early hypothyroid. Male gender, shorter duration of disease, smaller thyroid weight, lower 2-h radioactive iodine uptake (RAIU), 6-h RAIU, 24-h RAIU and 6/24-h uptake ratio, lower administered dosages were significantly associated with early hypothyroidism. Logistics regression analysis showed that male gender, smaller thyroid weight and lower 6-h RAIU were associated with early hypothyroidism. Multi-factors combined ROC curve analysis suggested that the predictive power of male gender, smaller thyroid weight and lower 6-h RAIU for early hypothyroidism was 0.711.
Our results show that RAI is an effective therapy for GD and most of the cured patients became to hypothyroid within 6 months. Male gender, smaller thyroid weight and lower 6-h RAIU are the main risk factors for early hypothyroidism.
放射性碘(RAI)治疗是 Graves 病(GD)的重要治疗选择,RAI 治疗的主要副作用是甲状腺功能减退症,导致甲状腺功能减退症的因素仍存在争议。本回顾性研究的目的是阐明 RAI 治疗 Graves 病后早期发生甲状腺功能减退症的可能危险因素。
我们回顾了 2017 年 1 月至 2018 年 12 月期间接受 RAI 治疗的 312 例 GD 患者,收集了潜在的危险因素,并分析了这些变量与早期甲状腺功能减退症之间的关系。
在 6 个月的随访后,218 例(69.87%)患者被评估为早期甲状腺功能减退症。男性、疾病持续时间较短、甲状腺重量较小、2 小时放射性碘摄取率(RAIU)较低、6 小时 RAIU、24 小时 RAIU 和 6/24 小时摄取率、给予的剂量较低与早期甲状腺功能减退症显著相关。Logistics 回归分析表明,男性、较小的甲状腺重量和较低的 6 小时 RAIU 与早期甲状腺功能减退症相关。多因素联合 ROC 曲线分析表明,男性、较小的甲状腺重量和较低的 6 小时 RAIU 对早期甲状腺功能减退症的预测能力为 0.711。
我们的结果表明,RAI 是治疗 GD 的有效方法,大多数治愈的患者在 6 个月内都会发生甲状腺功能减退症。男性、较小的甲状腺重量和较低的 6 小时 RAIU 是早期甲状腺功能减退症的主要危险因素。