Pfeilschifter J, Elser H, Haufe S, Ziegler R, Georgi P
Abteilung für Innere Medizin I, Medizinische Universitätsklinik, Deutschland.
Nuklearmedizin. 1997 Apr;36(3):81-6.
We examined the impact of several pretreatment variables on thyroid size and function in 61 patients with Graves' disease one year after a standardized [131]I treatment with 150 Gray.
FT3, FT4, and TSH serum concentrations were determined before and 1.5, 3, 6, and 12 months after therapy. Thyroid size was measured by ultrasound and scintigraphy before and one year after therapy.
One year after therapy, 30% of the patients had latent or manifest hyperthyroidism, 24% were euthyroid, and 46% had developed latent or manifest hypothyroidism. Age and initial thyroid volume were major predictors of post-therapeutical thyroid function. Thus, persistent hyperthyroidism was observed in 70% of the patients age 50 years and older with a thyroid size of more than 50 ml. With few exception, thyroid size markedly decreased after therapy. Initial thyroid size and age were also major predictors of posttherapeutical thyroid volume. Thyroid size normalized in all patients younger than 50 years of age, independent from initial thyroid size.
Radioiodine treatment with 150 Gray causes a considerable decrease in thyroid size in most patients with Graves' disease. Age and initial thyroid volume are important determinants of thyroid function and size after therapy and should be considered in dose calculation.
我们研究了61例格雷夫斯病患者在接受150格雷标准化[131]I治疗一年后，几种预处理变量对甲状腺大小和功能的影响。
在治疗前以及治疗后1.5、3、6和12个月测定血清FT3、FT4和TSH浓度。在治疗前和治疗一年后通过超声和闪烁扫描测量甲状腺大小。
治疗一年后，30%的患者有潜在或明显的甲状腺功能亢进，24%的患者甲状腺功能正常，46%的患者出现潜在或明显的甲状腺功能减退。年龄和初始甲状腺体积是治疗后甲状腺功能的主要预测因素。因此，在年龄50岁及以上、甲状腺大小超过50毫升的患者中，70%观察到持续性甲状腺功能亢进。除少数例外，治疗后甲状腺大小明显减小。初始甲状腺大小和年龄也是治疗后甲状腺体积的主要预测因素。所有年龄小于50岁的患者甲状腺大小均恢复正常，与初始甲状腺大小无关。
150格雷的放射性碘治疗可使大多数格雷夫斯病患者的甲状腺大小显著减小。年龄和初始甲状腺体积是治疗后甲状腺功能和大小的重要决定因素，在剂量计算中应予以考虑。
