Debrand-Passard A, Barzen G, Richter W, Wenzel K W, Felix R
Strahlenklinik und Poliklinik, Universitätsklinikum Rudolf Virchow, Standort Berlin-Charlottenburg.
Med Klin (Munich). 1994 Jun 15;89(6):319-23.
The result of radioiodine treatment administered to 126 patients with hyperthyroidism between 1986 and 1991 were analysed retrospectively. The indications for radioiodine treatment were single hyperfunctioning nodules (n = 47), multinodular goitre (n = 33), diffuse goitre (n = 19) and Graves' disease (n = 27); the respective doses of 131I, calculated with the Doering and Kramer formula, were 300 Gy (30,000 rad), 150 to 200 Gy (15,000 to 20,000 rad), 100 to 120 Gy (100,000 to 120,000 rad) and 100 Gy (100,000 rad). The uptake of radioiodine was measured on a daily basis and in the case of 46 patients (36.5%) additional treatment given on the third day of treatment.
For the patients undergoing regular follow-up, data were collected in 1992, at least six months post-therapy. Evaluation revealed a total applied dose of 131I of 20 +/- 12.4 mCi (median +/- SD) per patient. non-response to treatment making hospitalisation and renewed therapy necessary was observed in 1.6% of the group. In only two further patients did scintigraphy reveal compensated toxic adenoma. In 36% of patients with single hyperfunctioning nodules, 21% of those with multinodular goitre, 53% of those with diffuse goitre and 56% of those with Graves' disease hyperthyroidism was observed. In the great majority of cases, hypothyroidism occurred in the first year following treatment.
回顾性分析了1986年至1991年间对126例甲状腺功能亢进患者进行放射性碘治疗的结果。放射性碘治疗的适应证为单发高功能结节(n = 47)、多结节性甲状腺肿(n = 33)、弥漫性甲状腺肿(n = 19)和格雷夫斯病(n = 27);根据Doering和Kramer公式计算的131I各自剂量分别为300 Gy(30,000拉德)、150至200 Gy(15,000至20,000拉德)、100至120 Gy(100,000至120,000拉德)和100 Gy(100,000拉德)。每天测量放射性碘摄取量,46例患者(36.5%)在治疗第三天进行了额外治疗。
对于接受定期随访的患者,于1992年收集数据,此时治疗后至少已过去六个月。评估显示每位患者131I的总应用剂量为20±12.4毫居里(中位数±标准差)。该组中有1.6%的患者对治疗无反应,需要住院并重新治疗。仅另外两名患者的闪烁扫描显示为代偿性毒性腺瘤。在单发高功能结节患者中,36%出现甲状腺功能亢进;多结节性甲状腺肿患者中为21%;弥漫性甲状腺肿患者中为53%;格雷夫斯病患者中为56%。在绝大多数情况下,治疗后第一年出现甲状腺功能减退。