Roudebush C P, Hoye K E, DeGroot L J
Ann Intern Med. 1977 Oct;87(4):441-3. doi: 10.7326/0003-4819-87-4-441.
To minimize the high rate of residual thyrotoxicosis encountered in low-dose 131I therapy of Graves' disease, we have treated 62 patients with a low-dose 131I protocol that includes a compensation for thyroid size. Dose varied between 40 muCi retained/g for glands of normal size to 100 muCi/g for glands of 100 g or greater. Mean dose was 51.9 muCi/g. At 1 year after therapy, 66.1% of subjects were euthyroid, 9.7% hypothyroid, and 24.2% hyperthyroid, a significant improvement (P less than 0.01) over our previous experience using 50 muCi/g independent of gland size. Several factors, other than 131I dose, which might influence the outcome of therapy, were investigated. Initial free thyroxine index observed before therapy was found to have prognostic significance. Hypothyroidism developed only in patients having an initial free thyroxine index of 22.5 or less (about 2.5 times the upper limit of normal in our laboratory).
为将格雷夫斯病低剂量¹³¹I治疗中出现的高残留甲状腺毒症发生率降至最低，我们采用了一种低剂量¹³¹I方案治疗62例患者，该方案包括对甲状腺大小的补偿。剂量范围为正常大小腺体每克保留40微居里至100克或更大腺体每克100微居里。平均剂量为每克51.9微居里。治疗后1年，66.1%的患者甲状腺功能正常，9.7%甲状腺功能减退，24.2%甲状腺功能亢进，与我们之前使用每克50微居里且不考虑腺体大小的经验相比有显著改善（P<0.01）。研究了除¹³¹I剂量外可能影响治疗结果的几个因素。发现治疗前观察到的初始游离甲状腺素指数具有预后意义。甲状腺功能减退仅发生在初始游离甲状腺素指数为22.5或更低的患者中（约为我们实验室正常上限的2.5倍）。
