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目的 131Ⅰ治疗巨大甲状腺肿合并Graves甲状腺功能亢进(甲亢)的效果及其影响因素。方法对2010年1月~2012年5月在广东省惠州市中心人民医院应用131Ⅰ碘治疗巨大甲状腺肿合并Graves甲亢的210例患者,运用超声及单光子发射计算机断层成像术(Single-Photon Emission Computed Tomography,SPECT)估重等方法,测定患者甲状腺的重量为(125.0±37.1)g,其中男性患者76例,女性患者134例,平均年龄为(42.5±7.1)岁。根据患者的个体差异性,将131Ⅰ按照每克甲状腺组织1.96~6.21MBq/g进行给药,随访时间为(16.2±8.2)个月。结果经过131Ⅰ治疗后的3个月,130例患者(61.9%)甲状腺功能恢复正常,52例患者(24.8%)甲状腺功能亢进,28例患者(13.3%)甲状腺功能减退,其中有182例(86.7%)甲状腺肿大恢复正常,剩余患者甲状腺的质量均有所减小。经过131Ⅰ治疗后的6个月,162例患者(77.1%)甲状腺功能恢复正常,41例患者(19.5%)甲状腺功能亢进,7例患者(3.3%)甲状腺功能减退,其中有195例(92.9%)甲状腺肿大恢复正常,剩余患者甲状腺的质量均有所减小。结论运用131Ⅰ碘治疗巨大甲状腺肿合并Graves甲亢,可以使患者症状得到有效缓解,同时减少患者痛苦。同时在临床使用过程中应采用个体化剂量,可达到更加良好的效果。
Objective 131 Ⅰ treatment of giant goiter with Graves hyperthyroidism (hyperthyroidism) effect and its influencing factors. Methods From January 2010 to May 2012, 210 patients with giant goiter and Graves’ hyperthyroidism treated with 131 Ⅰ iodine in People’s Hospital of Huizhou City, Guangdong Province were enrolled in this study. Ultrasound and single-photon emission computed tomography (125.0 ± 37.1) g, including 76 males and 134 females, with an average age of (42.5 ± 7.1) years. According to the individual differences of patients, 131I was administered in the range of 1.96 ~ 6.21MBq / g per gram of thyroid tissue, and the follow-up time was (16.2 ± 8.2) months. Results Thirty-six patients (24.8%) had hyperthyroidism and 28 (13.3%) had hypothyroidism, of which 182 (86.7%) had normal thyroid function at 3 months after 131I treatment %) Goiter returned to normal, the remaining thyroid patients have been reduced in quality. Six months after 131I treatment, 162 patients (77.1%) returned to normal thyroid function, 41 (19.5%) had hyperthyroidism and 7 (3.3%) had hypothyroidism, of which 195 (92.9% ) Goiter returned to normal, the remaining thyroid quality have been reduced. Conclusion 131I iodine treatment of giant goiter with Graves hyperthyroidism, patients can effectively alleviate the symptoms, while reducing patient pain. At the same time in the clinical use of the individual dose should be used to achieve more good results.