放射性碘131治疗Graves病疗效的影响因素研究

摘要

目的：探讨放131I治疗Graves病的临床治疗效果及其影响因素。方法：选择我院内科2010年1月～2012年12月期间首次接受131I治疗Graves病的住院患者164例,采用自身对照配对设计试验方法。分析131I治疗前及治疗后12月甲状腺球蛋白抗体(TGA)、甲状腺微粒体抗体(TMA)、甲状腺重量、甲状腺最高摄131I率等因素对治疗效果的影响。结果：131I治疗Graves’治愈率达60.4%(62/164),有效率为90.2%(153/164)。单因素分析结果显示,TGA、TMA、甲状腺最高摄131I率、甲状腺重量分别为(22.0±17.5)、(15.9±12.3)、(6.2±1.3)、(4.4±1.5),明显低于无效组(38.2±9.8)、(28.5±10.5)、(8.6±0.9)、(9.2±2.3),差异均有统计学意义(P<0.05)。Logistic回归分析显示,甲状腺最高摄131I率(OR=0.904)、甲状腺重量(OR=0.912)与131I治疗Graves疗效有关。结论：131I治疗Graves病疗效好,治疗时应综合考虑甲状腺最高摄131I率、甲状腺重量等因素。%Objective:To study the therapeutic effect of disease and it's influencing factors.Methods:164 patients who firstly accepted 131I treatment on Graves’ form Jan 2010 to Dem. 2010 in the hospital were analyzed with the paired design.The relationship of therapeutic effects to TGA、TMA、thyroid weight and maximum thyroid intake 131I rate were compared before and 12 months after therapy.Results:The cure rate of 131I treatment on Graves was 60.4%(62/164), the effective rate was 90.2%(153/164).Univariate analysis showed that TGA, TMA, maximum thyroid intake 131I rate,thyroid weight were(22.0±17.5)、( 15.9±12.3)、( 6.2±1.3)、( 4.4±1.5),significantly lower than those (38.2±9.8)、( 28.5±10.5)、( 8.6±0.9)、( 9.2±2.3)in the ineffective group.The differences were significant (P<0.05). Logistic regression showed thatmaximum thyroid intake 131I rate(OR=0.904), thyroid weight(OR=0.912)were correlative with the therapeutic effect.Conclusion:The efficacy of131I treatment on Graves’ disease was high, and maximum thyroid intake 131I rate, thyroid weight etc. should consider when treatment.