CAJ | 학술논문

目的对比分析甲状腺动脉介人栓塞和131I治疗Graves病近期疗效的差异.方法对接受131I和甲状腺动脉栓褰治疗的各42例Graves病患者,行造影、SPECT/CT显像检查治疗前后甲状腺形态、大小,放射免疫法检测治疗前后3、6和12个月血清中FT3、FF4、TSH浓度及促甲状腺受体抗体(TRAb)活度和治疗后并发症出现的关系,并对以上数据进行统计学分析.结果两种治疗方法近期疗效无显著差异,介入治疗组治疗后早期严重并发症的发生率明显高于131I治疗组,而131I治疗组有更高的甲状腺功能减退(甲减)发生率.结论甲状腺动脉介入栓塞和131I治疗Graves病患者疗效肯定,131可用于初诊及其他方法疗效不佳的患者,介入栓塞治疗可用于抗甲状腺药物疗效不佳、无法手术及甲状腺摄131I率低不能行131I治疗者,特别对一些难治性、顽固性甲状腺功能亢进有效.介入疗法可作为Graves病可选择的手段.
목적 대비분석갑상선동맥개인전새화131I치료Graves병근기료효적차이.방법 대접수131I화갑상선동맥전건치료적각42례Graves병환자,행조영、SPECT/CT현상검사치료전후갑상선형태、대소,방사면역법검측치료전후3、6화12개월혈청중FT3、FF4、TSH농도급촉갑상선수체항체(TRAb)활도화치료후병발증출현적관계,병대이상수거진행통계학분석.결과 량충치료방법근기료효무현저차이,개입치료조치료후조기엄중병발증적발생솔명현고우131I치료조,이131I치료조유경고적갑상선공능감퇴(갑감)발생솔.결론 갑상선동맥개입전새화131I치료Graves병환자료효긍정,131가용우초진급기타방법료효불가적환자,개입전새치료가용우항갑상선약물료효불가、무법수술급갑상선섭131I솔저불능행131I치료자,특별대일사난치성、완고성갑상선공능항진유효.개입요법가작위Graves병가선택적수단.
Objective To compare the short-term effects between interventional arterial embolization and iodine-131 therapy in treating Graves'disease.Methods A total of 84 patients with Graves'disease (GD),confirmed by clinical data and laboratory tests,were divided into two groups:interventional group(n=42)receiving arterial embolization and iodine-131 group(n=42)receiving iodine-131 therapy.Before and after the treatment thyroid angiography and SPECT/CT imaging were performed to determine the shape and size of the thyroid,and radioimmunoassay method was used to measure serum levels of FT3,VF4,TSH and TRAb at 3.6 and 12 months after the therapy.The results were compared and statistically analyzed.The occurrence of complications was observed. Results No statistically significant difference in short-term therapeutic effects was found between interventional group and iodine-131 group.The occurrence of early severe complication was much higher in interventional group than that in iodine-131 group,while the occurrence of hypothyroidism was obviously higher in iodine-131 group than that in interventionai group.Conclusion Both interventional embolization and iodine-131 therapy have reliable effect for the treatment of Graves'disease.Iodine-131 therapy may be used in patients who plan to receive initial treatment or in patients who failed to effectively respond to other kinds of therapies,while interventional embolization may be employed in patients who are not able to receive surgery or in patients who have failed to respond to antithyroid drug treatment,or in patients whose iodine-131 intake rate is too low to undergo iodine-131 therapy,especially in patients with refractory and intractable hyperthyroidism. Interventional embolization can be regarded as an alternative treatment for Graves'disease.