Department of Endocrinology, The Second Affiliated Hospital of Anhui Medical University, Hefei, China.
Division of Endocrinology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Diabetes Obes Metab. 2024 Oct;26(10):4397-4409. doi: 10.1111/dom.15790. Epub 2024 Jul 18.
To investigate the impact of various clinical factors associated with Graves' disease on the success rate of radioiodine (RAI) therapy for Graves' disease within 3 years, and to determine the optimal range of iodine dosage per unit volume that yields the highest cure rate for Graves' disease within 1 year.
This retrospective study included patients diagnosed with Graves' disease who underwent RAI therapy at the Second Affiliated Hospital of Anhui Medical University between October 2012 and October 2022. The cumulative success rate was analysed using the Kaplan-Meier method. Univariate and multivariate Cox proportional hazards regression models were employed to evaluate factors associated with successful treatment of Graves' disease. Outcomes were categorized as either success or failure for all patients.
Overall, 1994 patients were enrolled in this study, including 594 (29.8%) male and 1399 (70.2%) female patients. The success and failure groups comprised 1645 (82.4%) and 349 patients (17.6%), respectively, after a 3-year follow-up period. Multivariate regression analysis demonstrated that sex, antithyroid drug (ATD) use before RAI therapy, age, thyroid receptor antibody (TRAb) levels, iodine dose, thyroid mass, and early ATD use before RAI therapy were independent influencing factors for Graves' disease cure.
We found that female patients and those with TRAbs ≥31.83 IU/L and thyroid mass ≥ 73.42 g had a lower cure rate. Therefore, thyroid size, disease severity, and duration of disease should be comprehensively considered when making treatment decisions and iodine dose selection in clinical practice.
探讨 Graves 病相关的各种临床因素对 Graves 病患者接受放射性碘（RAI）治疗后 3 年内成功率的影响，并确定在 1 年内获得最高 Graves 病治愈率的碘剂量单位体积的最佳范围。
本回顾性研究纳入了 2012 年 10 月至 2022 年 10 月在安徽医科大学第二附属医院接受 RAI 治疗的 Graves 病患者。采用 Kaplan-Meier 法分析累积成功率。采用单因素和多因素 Cox 比例风险回归模型评估与 Graves 病治疗成功相关的因素。所有患者的结局均分为成功和失败。
共有 1994 例患者纳入本研究，其中 594 例（29.8%）为男性，1399 例（70.2%）为女性。3 年随访后，成功组和失败组分别包括 1645 例（82.4%）和 349 例（17.6%）患者。多因素回归分析显示，性别、RAI 治疗前使用抗甲状腺药物（ATD）、年龄、甲状腺受体抗体（TRAb）水平、碘剂量、甲状腺质量和 RAI 治疗前早期使用 ATD 是 Graves 病治愈的独立影响因素。
我们发现女性患者和 TRAb≥31.83IU/L 且甲状腺质量≥73.42g 的患者治愈率较低。因此，在临床实践中制定治疗决策和选择碘剂量时，应综合考虑甲状腺大小、疾病严重程度和病程长短。
