Hall P, Lundell G, Holm L E
Department of General Oncology, Radiumhemmet, Karolinska Hospital, Stockholm, Sweden.
Acta Endocrinol (Copenh). 1993 Mar;128(3):230-4. doi: 10.1530/acta.0.1280230.
Causes of death were studied in 10,552 Swedish hyperthyroid patients treated with 131I diagnosed between 1950 and 1975. The patients were followed for an average of 15 years (range 0-35 years) and were matched with the Swedish Cause of Death Register. A total of 5,400 deaths were observed and the overall standardized mortality ratio was 1.47 (95% confidence interval (CI) 1.43-1.51). The standardized mortality ratio for females was 1.50 (95% CI 1.46-1.55) compared to 1.31 (95% CI 1.23-1.39) in males. The most common cause of death (61%) was from cardiovascular diseases (standardized mortality ratio 1.65; 95% CI 1.59-1.71). Significantly elevated risks were also seen for tumours, diseases of the endocrine system, respiratory system, gastro-intestinal system, and congenital malformations. In all causes of death, except tumours and trauma, decreasing standardized mortality ratios over time were seen. Patients followed for more than 10 years had significantly elevated risks for tumours, diseases of the endocrine, respiratory, and cardiovascular systems. Patients given higher 131I activity and younger patients had higher standardized mortality ratios than those given lower activity and older patients. The hyperthyroidism per se, rather than the 131I treatment, appeared to be the major explanation for the elevated mortality.
对1950年至1975年间确诊并接受¹³¹I治疗的10552例瑞典甲状腺功能亢进患者的死因进行了研究。对这些患者平均随访了15年（范围0 - 35年），并与瑞典死亡原因登记册进行了匹配。共观察到5400例死亡，总体标准化死亡率为1.47（95%置信区间（CI）1.43 - 1.51）。女性的标准化死亡率为1.50（95%CI 1.46 - 1.55），男性为1.31（95%CI 1.23 - 1.39）。最常见的死亡原因（61%）是心血管疾病（标准化死亡率1.65；95%CI 1.59 - 1.71）。肿瘤、内分泌系统疾病、呼吸系统疾病、胃肠道系统疾病和先天性畸形的风险也显著升高。在所有死因中，除肿瘤和创伤外，随时间推移标准化死亡率呈下降趋势。随访超过10年的患者患肿瘤、内分泌、呼吸和心血管系统疾病的风险显著升高。接受¹³¹I活度较高的患者和年轻患者的标准化死亡率高于接受活度较低的患者和老年患者。甲状腺功能亢进本身而非¹³¹I治疗似乎是死亡率升高的主要原因。
