Zhao Aomei, Zhang Jing, Xue Jianjun, Lu Xueni, Wang Qi, Ji Ting, Yang Lulu, Yu Yan, Yang Aimin
Department of Nuclear Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, People's Republic of China.
School of Public Health, Health Science Center of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, People's Republic of China.
Sci Rep. 2024 Dec 28;14(1):31148. doi: 10.1038/s41598-024-82521-5.
In China, due to the risks of hypothyroidism after radioiodine treatment, radioiodine is not commonly used as a first-line treatment. In this study, factors influencing the development of hypothyroidism after I therapy for Graves' hyperthyroidism were evaluated. This was a retrospective study with a 12-month follow-up. Retrospectively, we investigated 1,264 patients with diagnosed Graves' disease who received I therapy using the Marinelli-Quimby formula. The first three months after I therapy, hypothyroidism risk was higher among patients with lighter thyroid weight, higher levels of thyroglobulin antibody (TGAb), and shorter durations of Antithyroid drug (ATD) treatment before I therapy (P < 0.05). After 6 months, patients with lighter thyroid weight, shorter ATD treatment duration before I therapy, and higher iodine intake showed an increased risk of hypothyroidism. (P < 0.05). After one year, lower 24-h iodine uptake was the only risk factor for hypothyroidism (P < 0.05). Our results show that I is an effective therapy for GD. Even if over time, the occurrence of hypothyroidism may ultimately depend on the patients' radiosensitivity to I before treatment. But in the first 3 to 6 months or even one year, we can still take measures to effectively improve the quality of life of patients.
在中国，由于放射性碘治疗后存在甲状腺功能减退的风险，放射性碘通常不作为一线治疗方法。在本研究中，评估了格雷夫斯甲亢患者接受碘治疗后发生甲状腺功能减退的影响因素。这是一项为期12个月随访的回顾性研究。我们回顾性调查了1264例确诊为格雷夫斯病并使用马利内利 - 昆比公式接受碘治疗的患者。碘治疗后的前三个月，甲状腺重量较轻、甲状腺球蛋白抗体（TGAb）水平较高以及碘治疗前抗甲状腺药物（ATD）治疗时间较短的患者发生甲状腺功能减退的风险较高（P < 0.05）。6个月后，甲状腺重量较轻、碘治疗前ATD治疗时间较短以及碘摄入量较高的患者发生甲状腺功能减退的风险增加（P < 0.05）。一年后，24小时碘摄取率较低是发生甲状腺功能减退的唯一危险因素（P < 0.05）。我们的结果表明，碘是治疗格雷夫斯病的有效方法。即使随着时间推移，甲状腺功能减退的发生最终可能取决于患者治疗前对碘的放射敏感性。但在最初的3至6个月甚至一年时间里，我们仍可采取措施有效改善患者的生活质量。
