Alvi Asim Munir, Azmat Umal, Shafiq Waqas, Ali Rasheed Abdul Hannan, Siddiqi Ahmed Imran, Khan Sardar, Ashfaq Sara, Irfan Hira, Bashir Humayun, Abu Bakar Muhammad, Asghar Kashif
Endocrinology, Diabetes and Metabolism, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, PAK.
Nephrology and Hypertension, Loyola University Medical Center, Chicago, USA.
Cureus. 2022 May 14;14(5):e24992. doi: 10.7759/cureus.24992. eCollection 2022 May.
Background Radioactive iodine (RAI) is the treatment of choice for most patients with primary hyperthyroidism. The most common etiologies of hyperthyroidism are Graves' disease (GD), toxic adenoma (TA), and toxic multinodular goiter (TMNG). A single dose of RAI is usually sufficient to cure hyperthyroidism. The aim of this study was to assess the effectiveness of RAI therapy for patients diagnosed with primary hyperthyroidism. Methods and materials Patients diagnosed with hyperthyroidism who received RAI therapy between 2008 and 2018 were included in the study. The data was acquired from the hospital's electronic medical record system. Following the RAI treatment, a cure was defined as the development of euthyroidism or hypothyroidism after a single fixed-dose without antithyroid medication within one year of RAI therapy. In addition, a simple logistics regression model was used to identify the prognostic factors that may lead to better outcomes. Results A total of 112 patients diagnosed with hyperthyroidism with a mean age of 47 ± 14 were included in this study. The majority of the patients were female, 79 (70.5%). Within one year of RAI therapy, 84 (75%) patients achieved a cure that is either hypothyroid or euthyroid status. RAI dose was higher in responsive patients (18.50 ± 4.10 millicurie [mCi] versus 16.50 ± 4.10 mCi) than in non-responsive patients. The mean RAI doses were 16.05 ± 2.99 mCi in GD, 19.81 ± 4.40 mCi in TMNG, and 20.50 ± 3.30 mCi in TA, with a statistically significant p-value of 0.001. In the univariable logistic regression model, RAI dose was a significant prognostic factor of the responsive group (OR: 1.15, CI [1.01-1.31], p-value 0.03). Conclusion Our data presented that RAI therapy is effective for primary hyperthyroidism. We achieved remission with a single fixed-dose in the majority of patients. Most of our patients were cured within three months of RAI therapy. In addition, the RAI dose was higher in the responsive group as compared to the non-responsive group.
背景 放射性碘（RAI）是大多数原发性甲状腺功能亢进症患者的首选治疗方法。甲状腺功能亢进症最常见的病因是格雷夫斯病（GD）、毒性腺瘤（TA）和毒性多结节性甲状腺肿（TMNG）。单次剂量的RAI通常足以治愈甲状腺功能亢进症。本研究的目的是评估RAI治疗对诊断为原发性甲状腺功能亢进症患者的有效性。
方法和材料 本研究纳入了2008年至2018年间接受RAI治疗且诊断为甲状腺功能亢进症的患者。数据从医院的电子病历系统中获取。RAI治疗后，治愈的定义为在RAI治疗后一年内，在未使用抗甲状腺药物的情况下，单次固定剂量后出现甲状腺功能正常或甲状腺功能减退。此外，使用简单的逻辑回归模型来确定可能导致更好结果的预后因素。
结果 本研究共纳入112例诊断为甲状腺功能亢进症的患者，平均年龄为47±14岁。大多数患者为女性，共79例（70.5%）。在RAI治疗后的一年内，84例（75%）患者实现了治愈，即处于甲状腺功能减退或甲状腺功能正常状态。有反应的患者的RAI剂量（18.50±4.10毫居里[mCi]）高于无反应的患者（16.50±4.10 mCi）。GD患者的平均RAI剂量为16.05±2.99 mCi，TMNG患者为19.81±4.40 mCi，TA患者为20.50±3.30 mCi，p值为0.001，具有统计学意义。在单变量逻辑回归模型中，RAI剂量是有反应组的一个显著预后因素（OR：1.15，CI[1.01-1.31]，p值0.03）。
结论 我们的数据表明RAI治疗对原发性甲状腺功能亢进症有效。我们在大多数患者中通过单次固定剂量实现了缓解。我们的大多数患者在RAI治疗后三个月内治愈。此外，有反应组的RAI剂量高于无反应组。
