国际放射医学核医学杂志
國際放射醫學覈醫學雜誌
국제방사의학핵의학잡지
INTERNATIONAL JOURNAL OF RADIATION MEDICINE AND NUCLEAR MEDICINE
2013年
2期
69-73
,共5页
郑艳%赵德善%付松海%冯菲%耿会霞%孙琦婷%陆克义%李保军%李思进
鄭豔%趙德善%付鬆海%馮菲%耿會霞%孫琦婷%陸剋義%李保軍%李思進
정염%조덕선%부송해%풍비%경회하%손기정%륙극의%리보군%리사진
格雷夫斯病%碘放射性同位素%放射治疗剂量%近距离放射疗法%儿童%青少年
格雷伕斯病%碘放射性同位素%放射治療劑量%近距離放射療法%兒童%青少年
격뢰부사병%전방사성동위소%방사치료제량%근거리방사요법%인동%청소년
Graves disease%Iodine radioisotopes%Radiotherapy dosage%Brachytherapy%Child%Adolescent
目的 研究儿童和青少年Graves甲状腺功能亢进症(甲亢)患者接受131Ⅰ治疗的剂量范围.方法 回顾性分析经临床确诊、对抗甲状腺药物耐药或有临床禁忌证并接受131Ⅰ治疗的51例儿童和青少年甲亢患者及150例成年甲亢患者.两组患者均按甲状腺质量不同分为5组:第1组:≤30 g、第2组:31～50 g、第3组:51～70 g、第4组:71～90 g和第5组:＞90 g,儿童和青少年组与成年组间的各质量组间资料分布具有可比性.儿童和青少年组与成年组患者每克甲状腺组织所给予的131Ⅰ治疗剂量分别为(2.41±0.71) MBq/g和(3.27±0.97) MBq/g;总剂量分别为(224.36±130.10) MBq和(354.88±308.04) MBq.全部患者均行集中随访,儿童和青少年组131Ⅰ治疗后随访时间为24～83个月(平均32个月),成年组的随访时间为15～62个月(平均23个月),治疗结果分为痊愈、好转、甲减和复发.结果 随访结果发现,在接受131Ⅰ治疗的儿童和青少年组中,痊愈16例、出现永久性甲减22例、好转12例、复发1例；在成年组患者中,痊愈65例、出现永久性甲减56例、好转25例、复发4例；总有效率分别为98％和97.3％,儿童和青少年组与成年组的治疗疗效之间的差异无统计学意义(x2=0.058,P＞0.05).结论 在对抗甲状腺药物耐药或有临床禁忌证的儿童和青少年Graves甲亢患者行131Ⅰ治疗时,建议所给予的131Ⅰ应为成年人相应甲状腺质量所给131Ⅰ总剂量的63％左右或每克剂量的74％左右.
目的 研究兒童和青少年Graves甲狀腺功能亢進癥(甲亢)患者接受131Ⅰ治療的劑量範圍.方法 迴顧性分析經臨床確診、對抗甲狀腺藥物耐藥或有臨床禁忌證併接受131Ⅰ治療的51例兒童和青少年甲亢患者及150例成年甲亢患者.兩組患者均按甲狀腺質量不同分為5組:第1組:≤30 g、第2組:31～50 g、第3組:51～70 g、第4組:71～90 g和第5組:＞90 g,兒童和青少年組與成年組間的各質量組間資料分佈具有可比性.兒童和青少年組與成年組患者每剋甲狀腺組織所給予的131Ⅰ治療劑量分彆為(2.41±0.71) MBq/g和(3.27±0.97) MBq/g;總劑量分彆為(224.36±130.10) MBq和(354.88±308.04) MBq.全部患者均行集中隨訪,兒童和青少年組131Ⅰ治療後隨訪時間為24～83箇月(平均32箇月),成年組的隨訪時間為15～62箇月(平均23箇月),治療結果分為痊愈、好轉、甲減和複髮.結果 隨訪結果髮現,在接受131Ⅰ治療的兒童和青少年組中,痊愈16例、齣現永久性甲減22例、好轉12例、複髮1例；在成年組患者中,痊愈65例、齣現永久性甲減56例、好轉25例、複髮4例；總有效率分彆為98％和97.3％,兒童和青少年組與成年組的治療療效之間的差異無統計學意義(x2=0.058,P＞0.05).結論 在對抗甲狀腺藥物耐藥或有臨床禁忌證的兒童和青少年Graves甲亢患者行131Ⅰ治療時,建議所給予的131Ⅰ應為成年人相應甲狀腺質量所給131Ⅰ總劑量的63％左右或每剋劑量的74％左右.
목적 연구인동화청소년Graves갑상선공능항진증(갑항)환자접수131Ⅰ치료적제량범위.방법 회고성분석경림상학진、대항갑상선약물내약혹유림상금기증병접수131Ⅰ치료적51례인동화청소년갑항환자급150례성년갑항환자.량조환자균안갑상선질량불동분위5조:제1조:≤30 g、제2조:31～50 g、제3조:51～70 g、제4조:71～90 g화제5조:＞90 g,인동화청소년조여성년조간적각질량조간자료분포구유가비성.인동화청소년조여성년조환자매극갑상선조직소급여적131Ⅰ치료제량분별위(2.41±0.71) MBq/g화(3.27±0.97) MBq/g;총제량분별위(224.36±130.10) MBq화(354.88±308.04) MBq.전부환자균행집중수방,인동화청소년조131Ⅰ치료후수방시간위24～83개월(평균32개월),성년조적수방시간위15～62개월(평균23개월),치료결과분위전유、호전、갑감화복발.결과 수방결과발현,재접수131Ⅰ치료적인동화청소년조중,전유16례、출현영구성갑감22례、호전12례、복발1례；재성년조환자중,전유65례、출현영구성갑감56례、호전25례、복발4례；총유효솔분별위98％화97.3％,인동화청소년조여성년조적치료료효지간적차이무통계학의의(x2=0.058,P＞0.05).결론 재대항갑상선약물내약혹유림상금기증적인동화청소년Graves갑항환자행131Ⅰ치료시,건의소급여적131Ⅰ응위성년인상응갑상선질량소급131Ⅰ총제량적63％좌우혹매극제량적74％좌우.
Objective To analyze the radioactive 131Ⅰ dose of treatment in pediatric patients with Graves hyperthyroidism.Method Fifty one pediatric patients with hyperthyroidism and 150 adult patients with hyperthyroidism were retrospectively analyzed,who were contraindicated or refractory for medical therapy and treated with 131Ⅰ in this study.All pediatric and adult patients treated with 131Ⅰ were divided into five groups according to the thyroid weight.Group1:≤30 g,Group2:31～50 g,Group3:51～70 g,Group4:71 ～90 g and Group5:＞90 g.The pediatric patients were comparable to the adult patients in data distribution of the thyroid weight.All pediatric patients who were either contraindicated or refractory to antithyroid drugs treatment and adult patients received radioactive 131Ⅰ treatment with a dose of (2.41±0.71),(3.27±0.97)MBq/g thyroid tissue respectively.The total administrated doses of 131Ⅰ in all pediatric and adult patients were (224.36± 130.10) MBq and (354.88 ±308.04) MBq respectively.All the pediatric and adult patients treated with 131Ⅰ were followed-up (median 32 months,range 24 to 83 months; median 23 months,range 15 to 62 months,respectively).The treatment results were divided into euthyroid,hyperthyroidism,late-onset hypothyroidism and relapsed.Results The results by followed-up found that 16 and 65 patients became euthyroid,22 and 56 patients developed late-onset hypothyroidism,12 and 25 patients still had hyperthyroidism,1 and 4 patients relapsed after radioiodine therapy in pediatric group and adult group who were treated with 131Ⅰ,respectively.The total efficiency was 98％ and 97.3％,respectively.There were no statistical significance of treatment effect between pediatric and adult patients (x2=0.058,P＞0.05).Conclusion When the radioactive 131Ⅰ dose was administrated in pediatric patients with hyperthyroidism,who were contraindicated or refractory for medical therapy,it is recommended that the ratios of total 131Ⅰ dose administrated and that based on per gram thyroid tissue between pediatric and adult patients were 63％ and 74％,respectively.
