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用抗甲状腺药物和小剂量放射性碘治疗格雷夫斯病(作者译)

[The treatment of Graves' disease with antithyroid drugs and small doses of radioiodine (author's transl)].

作者信息

Jafiol C, Baldet L, Papachristou C, Lavit C, Mirouze J

出版信息

Ann Endocrinol (Paris). 1980 Nov-Dec;41(6):593-6.

PMID:6166243
Abstract

Three hundred and thirty Graves' disease patients (258 F. 72 M. ; mean age = 50 +/- 07 years) were treated by 131I from 1961 to 1979 ; 57 % had a goiter and 32 % had exophthalmos. One or several doses of radioiodine were given to each patient without dosimetry. The mean total dose (+/- SEM) was = 8,51 +/- 0,44 mCi and the mean for the first dose 4,34 +/- 4 ans 54,8 % of the patients received only one dose but 10,3 % of them had more than 3 doses. Data obtained by actuarial methods showed 66 % of the cases to be in remission in less than 2 years ; the frequency of hypothyroidism increased steadily by 3 % every year to give 15 % at 5 years and 30 % at 10 years. Remission was slower to occur in goitrous subjects and hypothyroidism was less frequent in this group despite doses significantly higher of radioiodine (p less than 0,001). Recovery was also slower among exophthalmos patients. Finally, the mean 3-hour radioiodine uptake and plasma T3 level were significantly lower six months after the first therapeutic dose among those who were cured of thier hyperthyroidism within two years.

摘要

1961年至1979年间,对330例格雷夫斯病患者(258例女性,72例男性;平均年龄 = 50 ± 7岁)进行了碘-131治疗;57%的患者有甲状腺肿,32%的患者有突眼症。在未进行剂量测定的情况下,给每位患者服用了一剂或几剂放射性碘。平均总剂量(±标准误)为8.51 ± 0.44毫居里,首剂平均剂量为4.34 ± 4,54.8%的患者仅接受了一剂,但其中10.3%的患者接受了超过3剂。通过精算方法获得的数据显示,66%的病例在不到2年的时间内缓解;甲状腺功能减退的发生率每年稳步上升3%,5年后为15%,10年后为30%。甲状腺肿患者缓解较慢,尽管放射性碘剂量明显较高(p < 0.001),但该组甲状腺功能减退的发生率较低。突眼症患者的恢复也较慢。最后,在两年内治愈甲亢的患者中,首次治疗剂量后6个月的平均3小时放射性碘摄取和血浆T3水平显著较低。

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