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放射性碘治疗的格雷夫斯病患者甲状腺功能亢进不愈或复发相关危险因素的性别差异

Sex-Related Differences in Risk Factors Associated With Nonhealing or Recurrence of Hyperthyroidism in Patients With Graves' Disease Treated With Radioactive Iodine.

作者信息

Shen Haolin, Wang Yuegui, Liao Jianmei, Zuo Xianbo, Zhang Bo, Yang Xiao

机构信息

Department of Ultrasound Medicine Zhangzhou Municipal Hospital Affiliated to Fujian Medical University Zhangzhou Fujian China.

Department of Dermatology China-Japan Friendship Hospital Beijing China.

出版信息

Health Care Sci. 2025 Jun 13;4(3):188-194. doi: 10.1002/hcs2.70021. eCollection 2025 Jun.

Abstract

BACKGROUND

To evaluate sex-related differences in the risk factors associated with nonhealing or recurrence of hyperthyroidism (NHRH) in patients with Graves' disease (GD) treated with radioactive iodine.

METHODS

In total, 285 patients were enrolled. Data on radioactive iodine (RAI) dosage, ultrasound indexes of the thyroid, and other clinical factors were collected. Patients were divided into NHRH and non-NHRH (hypothyroidism or euthyroidism) groups based on treatment outcomes. Univariate and multivariate weighted logistic regression analyses were used to identify factors associated with NHRH. Sex-specific analyses of these risk factors were also conducted.

RESULTS

There were no significant differences between the two groups in terms of sex, thyroid shear wave elastography velocity values, or pretreatment serum free thyroxine (FT4) levels. Thyroid volume and age were independently associated with NHRH, with the odds of NHRH gradually decreasing as age increased. In subgroup analyses, both age and thyroid volume were independent risk factors for NHRH in female patients ( < 0.05), while in male patients, only FT4 was independently associated with NHRH ( < 0.05).

CONCLUSIONS

In patients of different sexes, the influence of thyroid volume, age, and FT4 on treatment outcomes exhibits distinct patterns.

摘要

背景

评估接受放射性碘治疗的格雷夫斯病(GD)患者中,与甲状腺功能亢进症不愈合或复发(NHRH)相关的危险因素的性别差异。

方法

共纳入285例患者。收集放射性碘(RAI)剂量、甲状腺超声指标及其他临床因素的数据。根据治疗结果将患者分为NHRH组和非NHRH组(甲状腺功能减退或甲状腺功能正常)。采用单因素和多因素加权逻辑回归分析确定与NHRH相关的因素。还对这些危险因素进行了性别特异性分析。

结果

两组在性别、甲状腺剪切波弹性成像速度值或治疗前血清游离甲状腺素(FT4)水平方面无显著差异。甲状腺体积和年龄与NHRH独立相关,随着年龄的增加,NHRH的几率逐渐降低。在亚组分析中,年龄和甲状腺体积均为女性患者NHRH的独立危险因素(<0.05),而在男性患者中,只有FT4与NHRH独立相关(<0.05)。

结论

在不同性别的患者中,甲状腺体积、年龄和FT4对治疗结果的影响呈现出不同的模式。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b85a/12185363/e7a8b1b52117/HCS2-4-188-g002.jpg

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