Reinhardt M, Emrich D, Krause T, Bräutigam P, Nitzsche E, Blattmann H, Schümichen C, Moser E
Department of Nuclear Medicine, University of Freiburg, Germany.
Eur J Endocrinol. 1995 May;132(5):550-6. doi: 10.1530/eje.0.1320550.
The present study analyzes the improvement of the outcome of radioidine therapy in non-immunogenic hyperthyroidism by adapting the target dose to the 99mTc-pertechnetate thyroid uptake under suppression (TcTUs) prior to radioiodine therapy. The TcTUs is a substitute for the non-suppressible iodine turnover. The 89 patients presented with a basal thyrotropin level of < 0.1 mU/l, normal values for free triiodothyronine and thyroxine and with multifocal or disseminated thyroid autonomy. These terms describe the scintigraphic distribution pattern of autonomous iodine turnover. Thirty-two patients had a TcTUs between 1.6 and 3.2% (group A) and 57 had a TcTUs > 3.2% (group B). Fifty-five patients (three of group A and 52 of group B) were treated previously for overt hyperthyroidism with antithyroid drugs. Target doses of 150 and 200 Gy were used in both groups and 300 Gy in group B only. Six months after radioiodine therapy, a basal TSH level of > or = 0.5 mU/l as criterion of therapy success was observed in 94% of group A and in 54% of group B. Further differentiation of group B shows an increasing success rate with the target dose used: 45% after 150 Gy, 50% after 200 Gy and 90% after 300 Gy. In patients with a basal TSH level of < 0.5 mU/l after radioiodine therapy, the TcTUs was evaluated again.(ABSTRACT TRUNCATED AT 250 WORDS)
本研究通过在放射性碘治疗前根据抑制状态下的99m锝高锝酸盐甲状腺摄取量（TcTUs）调整目标剂量，分析了非免疫性甲状腺功能亢进症放射性碘治疗效果的改善情况。TcTUs可替代不可抑制的碘周转率。89例患者基础促甲状腺激素水平<0.1 mU/l，游离三碘甲状腺原氨酸和甲状腺素值正常，且存在多灶性或弥漫性甲状腺自主性。这些术语描述了自主性碘周转率的闪烁扫描分布模式。32例患者的TcTUs在1.6%至3.2%之间（A组），57例患者的TcTUs>3.2%（B组）。55例患者（A组3例，B组52例）此前曾用抗甲状腺药物治疗显性甲状腺功能亢进症。两组均使用150和200 Gy的目标剂量，B组仅使用300 Gy。放射性碘治疗6个月后，A组94%和B组54%的患者观察到基础促甲状腺激素水平≥0.5 mU/l作为治疗成功的标准。B组的进一步分析显示，随着所用目标剂量的增加成功率提高：150 Gy后为45%，200 Gy后为50%，300 Gy后为90%。放射性碘治疗后基础促甲状腺激素水平<0.5 mU/l的患者，再次评估TcTUs。（摘要截断于250字）
