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放射性碘治疗对甲状腺功能亢进症的影响(甲状腺功能、甲状腺体积、格雷夫斯眼病、甲状腺毒症性心脏病)

Effects of radioiodine therapy in hyperthyroidism (thyroid function, thyroid volume, Graves' ophtalmopathy, thyrotoxic heart disease).

作者信息

Ursu H I, Dumitriu L, Grigorie D, Simescu M, Vaida E, Belgun M, Popovici D

机构信息

C. I. Parhon Institute of Endocrinology, Bucharest, Romania.

出版信息

Rom J Endocrinol. 1993;31(3-4):155-63.

PMID:7697064
Abstract

The study group consisted of 135 hyperthyroid patients--128 with Graves' disease and 7 with toxic multinodular goiter. A single dose of radioiodine was given in 110 cases (81.48%), two doses in 22 patients (16.3%) and three doses in 3 patients (2.22%); mean total dose was 6.8 mCi (range = 3-24 mCi). The main goal of radio iodine therapy is to achieve euthyroidism; after radioiodine treatment, 61 patients (45.2%) were euthyroid, 60 patients (44.4%) with permanent hypothyroidism and 14 (10.36%) with PERSISTING HYPERTHYROIDISM--the mean duration of follow-up being 4.2 years. After radioiodine therapy, goiter became absent in 30 patients (28%); in those patients, goiter was moderately enlarged or large before therapy. Around 63% (12 cases) of the patients with thyrotoxic atrial fibrillation reverted to sinus rhythm. During the last four years (1990-1994) the patients with Graves' ophthalmopathy from the study group were treated with Prednisone after radioiodine therapy; this corticotherapy contributes to the lower percentage (1.5%) of worsening Graves' ophthalmopathy after radioiodine therapy.

摘要

研究组由135例甲状腺功能亢进患者组成,其中128例患有格雷夫斯病,7例患有毒性多结节性甲状腺肿。110例患者(81.48%)接受了单剂量放射性碘治疗,22例患者(16.3%)接受了两剂治疗,3例患者(2.22%)接受了三剂治疗;平均总剂量为6.8毫居里(范围为3 - 24毫居里)。放射性碘治疗的主要目标是实现甲状腺功能正常;放射性碘治疗后,61例患者(45.2%)甲状腺功能正常,60例患者(44.4%)出现永久性甲状腺功能减退,14例患者(10.36%)仍患有持续性甲状腺功能亢进,平均随访时间为4.2年。放射性碘治疗后,30例患者(28%)的甲状腺肿消失,这些患者在治疗前甲状腺肿为中度肿大或重度肿大。约63%(12例)甲状腺毒性心房颤动患者恢复为窦性心律。在过去四年(1990 - 1994年)中,研究组中患有格雷夫斯眼病的患者在放射性碘治疗后接受了泼尼松治疗;这种皮质激素疗法有助于降低放射性碘治疗后格雷夫斯眼病恶化的百分比(1.5%)。

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