中华核医学与分子影像杂志
中華覈醫學與分子影像雜誌
중화핵의학여분자영상잡지
Chinese Journal of Nuclear Medicine and Molecular Imaging
2013年
2期
120-123
,共4页
石丽红%蒋宁一%孙云凤%张占磊%张弘
石麗紅%蔣寧一%孫雲鳳%張佔磊%張弘
석려홍%장저일%손운봉%장점뢰%장홍
格雷夫斯病%白细胞减少%放射疗法%碘放射性同位素
格雷伕斯病%白細胞減少%放射療法%碘放射性同位素
격뢰부사병%백세포감소%방사요법%전방사성동위소
Graves disease%Leukopenia%Radiotherapy%Iodine radioisotopes
目的 探讨格雷夫斯甲状腺功能亢进(简称甲亢)合并WBC减少患者131I治疗后WBC的变化及其疗效评价.方法 回顾性分析257例临床确诊格雷夫斯甲亢并行131I治疗的患者,其中并发WBC减少者119例(WBC减少组),WBC正常者138例(WBC正常组).2组间年龄、甲状腺质量、24 h摄131I率、服131I剂量及病程差异均无统计学意义(均t＜0.972,均P＞0.05).WBC减少组为在131I治疗前WBC连续2次＜4.0×109/L,而正常组WBC在正常范围.测定131I治疗前及治疗后1、3、6和12个月的WBC,淋巴细胞、中性粒细胞及血小板计数,分别与治疗前进行比较,同时用临床治愈、好转、无效和甲状腺功能减退(简称甲减)评价131I治疗效果.用SPSS 13.0软件进行独立样本t检验、x2检验及单因素方差分析分析数据.结果 ZWBC减少组治疗前、治疗后1、3、6及12个月WBC分别为(3.49 ±0.43)×109/L、(4.06 ±0.98)×109/L、(4.20±1.04)×109/L、(4.37±0.93)×109/L和(4.88±1.20)×109/L；WBC正常组分别为(5.70±1.08)×109/L、(5.50±1.14) ×l09/L、(5.74 ±0.99)×109/L、(5.95±1.14)×109/L和(6.07±1.17)×109/L.正常组WBC计数治疗前和治疗后1个月比较差异无统计学意义(t=1.662,P＞0.05),而减少组WBC计数则差异有统计学意义(t =3.816,P＜0.05).WBC减少组131I治疗前后淋巴细胞无明显变化；中性粒细胞治疗前(1.59±0.46)×109/L,而治疗后1、3、6和12个月呈上升趋势(F=40.583,t=1.468～11.264,均P＜0.05)；而血小板治疗后6和12个月分别为(187.80±36.03)×109/L和(206.88±26.04)×109/L,高于治疗前(F=9.735,t =2.604和4.892,均P＜0.05).WBC正常组淋巴细胞除治疗后1个月[(1.79±0.37)×109/L]低于治疗前[(1.99±0.63)×109/L,F=12.868,t=3.284,均P＜0.05)]外,余差异均无统计学意义.疗效判断2组间差异无统计学意义(x2 =0.739,P＞0.05).结论 131I治疗格雷夫斯甲亢合并WBC减少患者,与WBC正常组疗效相似,治疗后绝大部分患者WBC可恢复到正常水平,是一种安全有效的治疗方法.
目的 探討格雷伕斯甲狀腺功能亢進(簡稱甲亢)閤併WBC減少患者131I治療後WBC的變化及其療效評價.方法 迴顧性分析257例臨床確診格雷伕斯甲亢併行131I治療的患者,其中併髮WBC減少者119例(WBC減少組),WBC正常者138例(WBC正常組).2組間年齡、甲狀腺質量、24 h攝131I率、服131I劑量及病程差異均無統計學意義(均t＜0.972,均P＞0.05).WBC減少組為在131I治療前WBC連續2次＜4.0×109/L,而正常組WBC在正常範圍.測定131I治療前及治療後1、3、6和12箇月的WBC,淋巴細胞、中性粒細胞及血小闆計數,分彆與治療前進行比較,同時用臨床治愈、好轉、無效和甲狀腺功能減退(簡稱甲減)評價131I治療效果.用SPSS 13.0軟件進行獨立樣本t檢驗、x2檢驗及單因素方差分析分析數據.結果 ZWBC減少組治療前、治療後1、3、6及12箇月WBC分彆為(3.49 ±0.43)×109/L、(4.06 ±0.98)×109/L、(4.20±1.04)×109/L、(4.37±0.93)×109/L和(4.88±1.20)×109/L；WBC正常組分彆為(5.70±1.08)×109/L、(5.50±1.14) ×l09/L、(5.74 ±0.99)×109/L、(5.95±1.14)×109/L和(6.07±1.17)×109/L.正常組WBC計數治療前和治療後1箇月比較差異無統計學意義(t=1.662,P＞0.05),而減少組WBC計數則差異有統計學意義(t =3.816,P＜0.05).WBC減少組131I治療前後淋巴細胞無明顯變化；中性粒細胞治療前(1.59±0.46)×109/L,而治療後1、3、6和12箇月呈上升趨勢(F=40.583,t=1.468～11.264,均P＜0.05)；而血小闆治療後6和12箇月分彆為(187.80±36.03)×109/L和(206.88±26.04)×109/L,高于治療前(F=9.735,t =2.604和4.892,均P＜0.05).WBC正常組淋巴細胞除治療後1箇月[(1.79±0.37)×109/L]低于治療前[(1.99±0.63)×109/L,F=12.868,t=3.284,均P＜0.05)]外,餘差異均無統計學意義.療效判斷2組間差異無統計學意義(x2 =0.739,P＞0.05).結論 131I治療格雷伕斯甲亢閤併WBC減少患者,與WBC正常組療效相似,治療後絕大部分患者WBC可恢複到正常水平,是一種安全有效的治療方法.
목적 탐토격뢰부사갑상선공능항진(간칭갑항)합병WBC감소환자131I치료후WBC적변화급기료효평개.방법 회고성분석257례림상학진격뢰부사갑항병행131I치료적환자,기중병발WBC감소자119례(WBC감소조),WBC정상자138례(WBC정상조).2조간년령、갑상선질량、24 h섭131I솔、복131I제량급병정차이균무통계학의의(균t＜0.972,균P＞0.05).WBC감소조위재131I치료전WBC련속2차＜4.0×109/L,이정상조WBC재정상범위.측정131I치료전급치료후1、3、6화12개월적WBC,림파세포、중성립세포급혈소판계수,분별여치료전진행비교,동시용림상치유、호전、무효화갑상선공능감퇴(간칭갑감)평개131I치료효과.용SPSS 13.0연건진행독립양본t검험、x2검험급단인소방차분석분석수거.결과 ZWBC감소조치료전、치료후1、3、6급12개월WBC분별위(3.49 ±0.43)×109/L、(4.06 ±0.98)×109/L、(4.20±1.04)×109/L、(4.37±0.93)×109/L화(4.88±1.20)×109/L；WBC정상조분별위(5.70±1.08)×109/L、(5.50±1.14) ×l09/L、(5.74 ±0.99)×109/L、(5.95±1.14)×109/L화(6.07±1.17)×109/L.정상조WBC계수치료전화치료후1개월비교차이무통계학의의(t=1.662,P＞0.05),이감소조WBC계수칙차이유통계학의의(t =3.816,P＜0.05).WBC감소조131I치료전후림파세포무명현변화；중성립세포치료전(1.59±0.46)×109/L,이치료후1、3、6화12개월정상승추세(F=40.583,t=1.468～11.264,균P＜0.05)；이혈소판치료후6화12개월분별위(187.80±36.03)×109/L화(206.88±26.04)×109/L,고우치료전(F=9.735,t =2.604화4.892,균P＜0.05).WBC정상조림파세포제치료후1개월[(1.79±0.37)×109/L]저우치료전[(1.99±0.63)×109/L,F=12.868,t=3.284,균P＜0.05)]외,여차이균무통계학의의.료효판단2조간차이무통계학의의(x2 =0.739,P＞0.05).결론 131I치료격뢰부사갑항합병WBC감소환자,여WBC정상조료효상사,치료후절대부분환자WBC가회복도정상수평,시일충안전유효적치료방법.
Objective To evaluate the effects of 131I treatment for Graves hyperthyroidism patients with leucopenia and the alteration of WBC levels after treatment.Methods A total of 257 Graves hyperthyroidism cases were retrospectively studied after 131I treatment.Based on baseline WBC count,119 cases with WBC count ＜4.0 × 109/L before 131I treatment were diagnosed with leucopenia and 138 cases had normal WBC.There were no significant differences in age,weight of thyroid,131I uptake rate in 24 h,dose of 131I and course of the disease between the two groups (all t ＜ 0.972,all P ＞ 0.05).WBC,lymphocyte,neutrophil and platelet counts were recorded before and 1,3,6 and 12 months after 131I therapy.The therapeutic effects were graded as clinical cure,improvement,invalidation and hypothyroidism.Statistical analyses,including independent samples t test,x2 test and one-way analysis of variance,were performed using SPSS 13.0.Results The WBC levels in the leucopenia group were (3.49 ± 0.43) × 109/L,(4.06 ±0.98) × 109/L,(4.20 ±1.04) × 109/L,(4.37 ±0.93) × 109/L and (4.88 ± 1.20) × 109/L before 131I treatment and 1,3,6,12 months after 131I treatment,respectively; while,those in the normal WBC group were (5.70 ± 1.08) × 109/L,(5.50 ± 1.14) × 109/L,(5.74 ±0.99) × 109/L,(5.95 ± 1.14) × 109/L and (6.07 ± 1.17) × 109/L,respectively.There was no statistically significant difference of WBC levels before and 1 month after 131 I treatment (t =1.662,P ＞ 0.05) in the normal WBC group,but WBC levels at those timepoints were significantly different in the leucopenia group (t =3.816,P ＜ 0.05).In the leucopenia group,there was no significant change of lymphocytes before and after 131I treatment,while the average neutrophil count showed an increasing trend during the 1,3,6 and 12 months after 131I treatment (F =40.583,t:1.468-11.264,all P ＜ 0.05).The average platelet counts at 6 and 12 months after 131I treatment were (187.80 ± 36.03) × 109/L and (206.88 ± 26.04) × 109/L respectively,which were higher than that before 131I treatment (F =9.735,t =2.604,4.892,all P ＜0.05).In the normal WBC group,there were no statistical differences of WBC changes before and after 131I treatment except for a lower lymphocyte count at 1 month after 131I treatment than that at baseline ((1.79 ± 0.37) × 109/L vs (1.99 ±0.63) × 109/L;F =12.868,t =3.284,both P ＜ 0.05).The treatment effects of the two groups were not significantly different (x2 =0.739,P ＞ 0.05).Conclusions 131I treatment presents similar therapeutic effects on Graves hyperthyroidism patients with leucopenia and those with normal WBC levels.WBC levels in patients with leucopenia may recover to baseline during the post-treatment follow-up.Thus 131I treatment is a safe and effective method for Graves hyperthyroidism patients with leucopenia.
