Reinhardt M J, Trupkovic T, Schumacher T, Krause T M, Oexle C, Moser E
Abteilung Nuklearmedizin, Klinikum der Albert-Ludwigs-Universität, Freiburg i. Br., Deutschland.
Nuklearmedizin. 1998;37(6):202-7.
The present study deals with the change of the 99mTechnetium-pertechnetate thyroid uptake under suppression (TcTUs) in dependence on the urinary iodine excretion.
The study collective comprises 510 patients with euthyroid goiter (N = 91), with functional thyroid autonomy (N = 361) and with Graves, disease (N = 58), who were examined in the own thyroid ambulance between January 1995 and February 1997 and who presented with endogeneous or exogeneous TSH suppression. All patients received a quantitative thyroid scintigraphy with 99mTechnetium-pertechnetate and a measurement of the urinary iodine excretion.
The TcTUs from the whole collective shows an inverse correlation to the urinary iodine excretion for the range of 0 to 500 micrograms iodine/g creatinine. The TcTUs remains constant on a low basal level for iodine excretion values over 500 micrograms iodine/g creatinine. Significant differences occur in dependence on the underlying disease. TcTUs is constantly low in patients with euthyroid goiter, independent of the iodine excretion value. The TcTUs is significantly increased in patients with functional thyroid autonomy or Graves' disease when iodine excretion is below 100 or 50 micrograms iodine/g creatinine respectively, but shows only minor changes when iodine excretion rises up to 500 micrograms iodine/g creatinine. When iodine excretion exceeds 500 micrograms iodine/g creatinine, the TcTUs of patients with thyroid autonomy drops down to a low basal level.
The reference range of TcTUs for assessing functional thyroid autonomy will not change significantly when the iodine supply in Germany improves. The TcTUs of patients with functional thyroid autonomy might be up to one third higher under conditions of iodine deficiency than in iodine sufficiency. This should be taken into account, when therapeutical consequences were derived from the TcTUs. The TcTUs cannot be interpreted for iodine excretion values over 500 micrograms iodine/g creatinine.
本研究探讨了在抑制状态下高锝[99mTc]酸盐甲状腺摄取量（TcTUs）随尿碘排泄的变化情况。
研究对象包括510例甲状腺功能正常的甲状腺肿患者（n = 91）、功能性甲状腺自主性患者（n = 361）和格雷夫斯病患者（n = 58），这些患者于1995年1月至1997年2月在本院甲状腺门诊接受检查，均存在内源性或外源性促甲状腺激素（TSH）抑制。所有患者均接受了高锝[99mTc]酸盐定量甲状腺闪烁扫描及尿碘排泄量测定。
在0至500微克碘/克肌酐范围内，整个研究群体的TcTUs与尿碘排泄呈负相关。当碘排泄值超过500微克碘/克肌酐时，TcTUs维持在较低的基础水平且保持恒定。根据基础疾病不同，结果存在显著差异。甲状腺功能正常的甲状腺肿患者的TcTUs持续较低，与碘排泄值无关。当碘排泄分别低于100或50微克碘/克肌酐时，功能性甲状腺自主性患者或格雷夫斯病患者的TcTUs显著升高，但当碘排泄升至500微克碘/克肌酐时，仅出现微小变化。当碘排泄超过500微克碘/克肌酐时，甲状腺自主性患者的TcTUs降至较低的基础水平。
当德国的碘供应改善时，用于评估功能性甲状腺自主性的TcTUs参考范围不会有显著变化。在碘缺乏条件下，功能性甲状腺自主性患者的TcTUs可能比碘充足时高出三分之一。从TcTUs得出治疗结论时应考虑到这一点。对于碘排泄值超过500微克碘/克肌酐的情况，无法对TcTUs作出解释。
