摘要
目的探讨纳入有效半减期计算投入剂量对^(131)I治疗Graves’甲亢(Graves disease,GD)转归的影响。方法收集本科2014年9月至2016年4月就诊患者中符合^(131)I治疗并同意采用该治疗的GD患者201例,采用抛币法分为对照组(n=79)和观察组(n=122)。测定所有患者2、4、24、48 h的甲状腺吸碘率,利用公式y=-4.555 1x+0.169 3计算有效半减期,观察组将有效半减期纳入公式计算投入剂量,对照组采用通用的计量法计算投入剂量,观察两组投入剂量、甲亢一次性缓解率、早发甲减率的差异。结果分别按观察组与对照组公式计算每位患者的投入剂量,观察组平均投入剂量较对照组减少1.46 mci(t=25.61,P<0.01);观察组与对照组一次性缓解率分别为94.93%、91.80%,两组差异有统计学意义(P>0.05);观察组早发甲减率为9.01%,显著低于对照组的16.46%(P<0.01);有效半减期≥6.0 d时,对照组早发甲减率62.5%,显著高于观察组的22.22%(P<0.01)。两组有效半减期在3.9~<4.5 d时,平均缓解率78.57%;4.5~<6.0 d时,平均缓解率94.11%;≥6.0 d时平均缓解率为96.15%。随着有效半减期的延长,平均缓解率逐渐增加(P<0.01)。结论基于个体有效半减期计算^(131)I投入量可减少治疗GD的投入剂量并提高一次性缓解率和降低早发甲减率。
Objective To determine the effect of calculating given dose of 131I based on effective halflife on the outcome of Graves disease. Methods A total of 201 Graves patients who were admitted in our hospital and consent our treatment plan in September 2014 to April 2016 were recruited in this study. They were randomly divided into control group （n=79） and observation group （n=122）. The thyroid iodine absorption rate in 2, 4, 24 and 48 h after oral administration were measured. The formula y=-4.555 1x＋0.1693 was used to calculate the effective half-life. The given dose was determined by inputting the effective half life into the formula for the observation group, while by common calculation method for the control group. The given dose and remission rate were compared between the 2 groups. Results The given dose of each patient was calculated, and the dose was averagely 1.46 mci lower in the observation group than the control （t=25.61, P〈0.01）. The remission rate was 94.93% and 91.80% respectively in the observation group and control group, with significant difference （P〈0.05）. The early onset of hypothyroidism was 9.01% in the observation group and 16.46% in the control group （P〈0.01）. When the effective halflife was over 6.0 d, the early onset of hypothyroidism was 62.5% in the control group, significantly higher than that of the observation group （22.22%, P〈0.01）. For the patients with effective halflife from 3.9 to 4.5 d, the remission rate was 78.57%, those with it ranging from 4.5 to 6.0 d, the rate was 94.11%, and with the duration longer than 6.0 d, the rate was 96.15%, so the rate was increased with the length of effective halflife （P〈0.01）. Conclusion Calculating given dose of 131I based on individual effective halflife can not only reduce the dose but also improve the remission rate as well as decrease the early onset of hypothyroidism in the the treatment of Graves disease.
出处
《第三军医大学学报》
CAS
CSCD
北大核心
2017年第21期2131-2134,共4页
Journal of Third Military Medical University
