Nygaard B, Hegedüs L, Gervil M, Jensen H H, Søe-Jensen P, Hansen J E
Medicinsk endokrinologisk afdeling F, Amtssygehuset i Herlev.
Ugeskr Laeger. 1994 Sep 26;156(39):5699-703.
The aim of this study was to investigate the long term effect of 131I treatment on thyroid function and size in patients with non-toxic multinodular goitre. The subjects were 69 consecutive patients with multinodular non-toxic goitre selected for 131I treatment and followed for a minimum of 12 months. Outcome measures were standard thyroid function variables and ultrasonically determined thyroid volume before and after treatment. Fifty-nine patients were treated with a single dose of 131I, 12 with two doses, and one with four doses. In 45 patients treated with one dose who remained euthyroid the median thyroid volume was reduced from 73 (interquartile range 50-106) ml to 29 (interquartile range 23-48) ml at 24 months. The median reduction was 40 (22-48) ml, half of which occurred within three months. Patients treated with two doses as well as those developing hypo- or hyper-thyroidism also had a significant reduction in thyroid volume. Eleven patients developed hypothyroidism (cumulative five year risk 22%). Side effects were few. In conclusion we find that 131I treatment of multinodular non-toxic goitre is an attractive alternative to surgery.
本研究的目的是调查¹³¹I治疗对非毒性多结节性甲状腺肿患者甲状腺功能和大小的长期影响。研究对象为连续69例接受¹³¹I治疗并至少随访12个月的多结节性非毒性甲状腺肿患者。观察指标为治疗前后的标准甲状腺功能变量和超声测定的甲状腺体积。59例患者接受单次¹³¹I治疗，12例接受两次治疗，1例接受四次治疗。在45例接受单次治疗且仍保持甲状腺功能正常的患者中，24个月时甲状腺体积中位数从73（四分位间距50 - 106）ml降至29（四分位间距23 - 48）ml。体积中位数减少40（22 - 48）ml，其中一半在三个月内发生。接受两次治疗的患者以及出现甲状腺功能减退或亢进的患者甲状腺体积也显著减小。11例患者出现甲状腺功能减退（累积五年风险22%）。副作用较少。总之，我们发现¹³¹I治疗多结节性非毒性甲状腺肿是一种有吸引力的手术替代方案。
