Khanna C M, Magdam M, Ravishankar L, Dham D N, Chugh P
Dept of Endocrinology Institute of Nuclear Medicine and Allied Sciences, Delhi.
J Assoc Physicians India. 1995 Oct;43(10):685-8.
Results of the long-term effects of two schedules of radioiodine therapy I131 in 130 toxic multinodular goitre patients were evaluated. Seventy five patients (group I) were treated with low doses and 55 patients (group II) with calculated high doses adjusted for thyroid weight (0.5-1 mci/g) and radioiodine uptake. Follow up (mean +/- SEM) was 4.5 +/- 0.4 years and 4.8 +/- 0.6 years respectively (P > 0.1). At the end of follow up, hyperthyroidism was successfully reversed in 78% (Group I) and 82% (Group II). In group I hypothyroidism was present in 5% of patients, while it was 12.5% in group II patients. The total dose per gram of thyroid tissue was not significantly different in both the groups (.058 mci +/- .0054 VS .073 +/- .0054 mci/g). However in group II the number of I131 administration was significantly lower (1.5 +/- 0.2) than in group I (3.2 +/- 0.4). The percentage of patients who were adequately treated in Group II with single dose was more as compared in group I (62% in group II versus 40% in group I). Euthyroidism was reached in a shorter time after treatment in group II (median time 0.8 year in group II Vs 1.1 yrs in group I) It is concluded that radioiodine is an effective treatment for toxic multinodular goitre with a significant low incidence of post therapy hypothyroidism in patients treated with low doses as compared to higher doses of radioiodine therapy.
评估了130例毒性多结节性甲状腺肿患者接受两种放射性碘（I131）治疗方案的长期效果。75例患者（I组）接受低剂量治疗，55例患者（II组）接受根据甲状腺重量（0.5 - 1毫居里/克）和放射性碘摄取量计算的高剂量治疗。随访时间（均值±标准误）分别为4.5±0.4年和4.8±0.6年（P>0.1）。随访结束时，I组78%、II组82%的患者甲亢成功得到逆转。I组5%的患者出现甲状腺功能减退，而II组患者中这一比例为12.5%。两组每克甲状腺组织的总剂量无显著差异（0.058毫居里±0.0054与0.073±0.0054毫居里/克）。然而，II组I131的给药次数显著低于I组（1.5±0.2）（I组为3.2±0.4）。II组单次给药充分治疗的患者百分比高于I组（II组为62%，I组为40%）。II组治疗后达到甲状腺功能正常的时间更短（II组中位时间为0.8年，I组为1.1年）。结论是，放射性碘是治疗毒性多结节性甲状腺肿的有效方法，与高剂量放射性碘治疗相比，低剂量治疗的患者治疗后甲状腺功能减退的发生率显著较低。
