CAJ | 학술논문

目的：回顾性分析重症甲状腺功能亢进（甲亢）患者131碘化钠（131 I）治疗后的随访结果与剂量的关系。方法选择2005年1月－2014年1月就诊于南京大学医学院附属鼓楼医院核医学科并接受131 I内照射治疗且随访时间大于1年的120例重症甲亢患者。入选标准：促甲状腺素（ thyroid stimulating hormone，TSH）＜0．005 mIU／L，游离三碘甲状腺原氨酸（ free triiodothyronine，FT3）＞50 pmol／L，游离甲状腺素（free thyroxine，FT4）＞100 pmol／L。结果在半固定剂量的前提下个体化剂量治疗1次或多次后，120例中完全缓解率为12．50％（15／120），1年以上甲减发生率为83．33％（100／120），以优甲乐25～125μg／d替代治疗，患者复发率4．17％（5／120）。结论应在可能的范围内调整131 I到最适剂量减少甲减发生率，提高完全缓解率，提高患者满意度。
목적：회고성분석중증갑상선공능항진（갑항）환자131전화납（131 I）치료후적수방결과여제량적관계。방법선택2005년1월－2014년1월취진우남경대학의학원부속고루의원핵의학과병접수131 I내조사치료차수방시간대우1년적120례중증갑항환자。입선표준：촉갑상선소（ thyroid stimulating hormone，TSH）＜0．005 mIU／L，유리삼전갑상선원안산（ free triiodothyronine，FT3）＞50 pmol／L，유리갑상선소（free thyroxine，FT4）＞100 pmol／L。결과재반고정제량적전제하개체화제량치료1차혹다차후，120례중완전완해솔위12．50％（15／120），1년이상갑감발생솔위83．33％（100／120），이우갑악25～125μg／d체대치료，환자복발솔4．17％（5／120）。결론응재가능적범위내조정131 I도최괄제량감소갑감발생솔，제고완전완해솔，제고환자만의도。
Objective To investigate the incidence of hypothyroidism and factors affecting the treatment effect of radioiodine therapy for severe Gravesˊdisease ( GD) more than 1 years after treatment.Methods 120 cases of GD in Nanjing drum tower hospital of Nanjing university medical school from January 2005 to January 2014 were retrospectively studied.Data including blood tests TSH<0.005 mIU/L, FT3>50 pmol/L and FT4>100 pmol/L, symptoms, signs, effective radioactive iodine uptake ( RAIU) , radioiodine doses and hypothyroidism incidences were collected.Hypothyroidism was also recorded.Student t-test was analyzed.Results The hy-pothyroidism incidence was 83.33%(100/120).Complete remission incidence was 12.50% (15/120).Recurrence incidence was 4.17%(5/120).Conclusion In order to decrease hypothyroidism incidence and enhance happiness, Optimum delivered 131I dose will be suggested to GD patients.