Saito S, Sakurada T, Yamamoto M, Yoshida K, Kaise K, Kaise N, Yoshinaga K
Tohoku J Exp Med. 1980 Sep;132(1):1-10. doi: 10.1620/tjem.132.1.
To evaluate the long-term results of 131I treatment for Graves' disease, the thyroid function was studied in 331 patients 5-17 years after this therapy. Twenty-five patients were hypothyroid and had already been on thyroid medication. Among the remaining 306 patients without any treatment for thyroid disorder, 188 patients (61.4%) had a normal thyroid-stimulating hormone (TSH) level (less than 10 microU/ml) of whom 151 were euthyroid with normal thyroxine (T4) and triiodothyronine (T3) level. 118 patients (38.6%) had a high TSH level, of whom 22 were hypothyroid with low T4 and T3 levels and 38 with normal T3 and low T4 levels, and 14 patients out of this 38 were clinically hypothyroid. Although all of the patients with high TSH levels do not per se require the replacement therapy for hypothyroidism, the overt hypothyroidism seems to occur sooner or later in patients with a lower T4 level. Among 331 patients studied, 61 (18.4%) were clinically hypothyroid. The incidence of hypothyroidism was 20.7% after 10 years of 131I treatment and 33% after 15-17 years. The incidence of patients with high TSH levels was 50% after 10 years of 131I treatment and 60% after 15-17 years. Both of cumulative incidence of hypothyroidism and patients with high TSH levels increased linearly with years after the treatment, which coincided with the linear decrease of mean T4 and T3 levels and linear increase of mean TSH level with years after the treatment. The difference of positive incidence of antithyroid antibodies between cases of normal TSH level and high TSH level was not significant.
为评估¹³¹I治疗Graves病的长期效果，对331例接受该治疗5至17年的患者的甲状腺功能进行了研究。25例患者为甲状腺功能减退，且已在接受甲状腺药物治疗。在其余306例未接受任何甲状腺疾病治疗的患者中，188例（61.4%）促甲状腺激素（TSH）水平正常（低于10微单位/毫升），其中151例甲状腺功能正常，甲状腺素（T4）和三碘甲状腺原氨酸（T3）水平正常。118例（38.6%）TSH水平升高，其中22例甲状腺功能减退，T4和T3水平低，38例T3正常但T4水平低，这38例中有14例临床甲状腺功能减退。虽然并非所有TSH水平升高的患者本身都需要进行甲状腺功能减退的替代治疗，但T4水平较低的患者迟早似乎会出现明显的甲状腺功能减退。在研究的331例患者中，61例（18.4%）临床甲状腺功能减退。¹³¹I治疗10年后甲状腺功能减退的发生率为20.7%，15至17年后为33%。¹³¹I治疗10年后TSH水平升高患者的发生率为50%，15至17年后为60%。甲状腺功能减退和TSH水平升高患者的累积发生率均随治疗后年份呈线性增加，这与治疗后年份平均T4和T3水平的线性下降以及平均TSH水平的线性增加相一致。TSH水平正常和升高的病例之间抗甲状腺抗体阳性发生率的差异不显著。
