Moka D, Voth E, Schicha H
Klinik und Poliklinik für Nuklearmedizin, Universität zu Köln, Deutschland.
Nuklearmedizin. 1997 Apr;36(3):87-92.
A radioiodine therapy (RIT) in thyrotoxic patients receiving antithyroid drugs (ATD) leads in comparison to nonpretreated patients either to higher therapeutic doses or to higher treatment failure rates. Aim of this study was to optimize the effect of RIT in patients pretreated with ATD.
Therefore, the influence of ATD was assessed in 109 patients with shortened effective half-life of 131I. RIT was performed under stationary conditions. Radioiodine activity of the thyroid gland was measured twice a day. In 77 patients antithyroid medication was stopped three days after RIT. The progress of the first RIT and of a second radioiodine application, which still was necessary in 29 patients, was compared to 32 patients receiving ATD, continuously.
Values of effective half-life for 131I rose significantly from 3.2 +/- 0.2 to 5.7 +/- 0.2 days (Graves' disease: 3.4 to 5.7 days; toxic goiters' disease: multifocal autonomy 3.2 to 6.2 days; unifocal autonomy 2.5 auf 5.0 days) 2-3 days after stopping ATD. There was an increase of the 131I-uptake of a second after stopping ATD, too. In contrast, 131I-uptake of a second RIT decreased significantly in patients receiving ATD, continuously.
Effective half-life and uptake of 131I was affected significantly by ATD. The stop taking of ATD after RIT is useful to improve an apparent insufficient RIT in thyrotoxic patients receiving ATD.
与未接受预处理的患者相比，接受抗甲状腺药物（ATD）治疗的甲状腺毒症患者进行放射性碘治疗（RIT）时，要么需要更高的治疗剂量，要么治疗失败率更高。本研究的目的是优化ATD预处理患者的RIT效果。
因此，在109例131I有效半衰期缩短的患者中评估了ATD的影响。RIT在住院条件下进行。每天测量两次甲状腺的放射性碘活性。77例患者在RIT后三天停用抗甲状腺药物。将首次RIT和第二次放射性碘治疗（29例患者仍需要进行第二次治疗）的进展情况与32例持续接受ATD治疗的患者进行比较。
停用ATD后2 - 3天，131I的有效半衰期值从3.2±0.2天显著升至5.7±0.2天（格雷夫斯病：从3.4天升至5.7天；毒性甲状腺肿疾病：多灶自主性从3.2天升至6.2天；单灶自主性从2.5天升至5.0天）。停用ATD后第二次治疗时131I摄取也增加。相比之下，持续接受ATD治疗的患者第二次RIT时131I摄取显著降低。
ATD对131I的有效半衰期和摄取有显著影响。RIT后停用ATD有助于改善接受ATD治疗的甲状腺毒症患者中明显不足的RIT。
