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放射性碘治疗甲状腺功能亢进症的临床结果:一项随访研究。

Clinical outcome of radioiodine treatment of hyperthyroidism: a follow-up study.

作者信息

Berg G, Michanek A, Holmberg E, Nyström E

机构信息

Department of Oncology, Sahlgrenska University Hospital, University of Göteborg, Sweden.

出版信息

J Intern Med. 1996 Feb;239(2):165-71. doi: 10.1046/j.1365-2796.1996.441788000.x.

Abstract

OBJECTIVES

To study the clinical outcome of treatment of hyperthyroid patients with radioiodine.

DESIGN

Records of patients treated for hyperthyroidism with radioiodine from 1989 to 1992 were examined in 1994, and a questionnaire was sent to patients < or = 70 years with Graves' disease (GD) and toxic nodular goitre (TNG) to obtain information regarding thyroxine substitution, smoking habits and present state of health.

SETTING

Outpatients in a thyroid unit; follow-up by primary care.

SUBJECTS

Seven hundred and fifty-four patients with hyperthyroidism treated with radioiodine, 327 receiving the questionnaire, 72% response rate.

INTERVENTION

Radioiodine treatment using a delivered absorbed dose method, aiming at an absorbed dose to the thyroid of 100-120 Gy.

MAIN OUTCOME MEASURES

Statistical analysis of clinical records and results from questionnaire.

RESULTS

Only 10% of the patients needed more than one treatment. At the time of follow-up, thyroxine supplementation was given to 178 (93%) of the GD and to 21 (47%) of the TNG patients. Smoking was more common in GD patients than in the general population (44% vs. 26%; P < 0.001). Smoking GD patients experienced eye discomfort more often than smoking TNG patients (53% vs. 7%; P < 0.001). Weight gain after therapy was a problem in 79% of the hyperthyroid individuals.

CONCLUSIONS

Few patients needed retreatment and most of the GD patients had thyroxine after 1-5 years after therapy. Smoking patients, especially those with GD, had more eye symptoms. At follow-up, the euthyroid patients still consider themselves having a poorer health than individuals in the general population.

摘要

目的

研究放射性碘治疗甲状腺功能亢进患者的临床疗效。

设计

1994年检查了1989年至1992年接受放射性碘治疗甲状腺功能亢进患者的记录,并向年龄≤70岁的格雷夫斯病(GD)和毒性结节性甲状腺肿(TNG)患者发送了问卷,以获取有关甲状腺素替代、吸烟习惯和健康现状的信息。

地点

甲状腺科门诊患者;由初级保健机构进行随访。

研究对象

754例接受放射性碘治疗的甲状腺功能亢进患者,327例收到问卷,回复率为72%。

干预措施

采用给予吸收剂量法进行放射性碘治疗,目标是使甲状腺的吸收剂量达到100 - 120戈瑞。

主要观察指标

对临床记录进行统计分析以及问卷结果。

结果

仅10%的患者需要不止一次治疗。在随访时,178例(93%)GD患者和21例(47%)TNG患者接受了甲状腺素补充治疗。GD患者吸烟比普通人群更常见(44%对26%;P < 0.001)。吸烟的GD患者比吸烟的TNG患者更常出现眼部不适(53%对7%;P < 0.001)。79%的甲状腺功能亢进患者治疗后体重增加是个问题。

结论

很少有患者需要再次治疗,大多数GD患者在治疗后1 - 5年接受了甲状腺素治疗。吸烟患者,尤其是GD患者,有更多眼部症状。在随访时,甲状腺功能正常的患者仍认为自己的健康状况比普通人群差。

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