目的 观察Graves病患者131 I治疗前后的血流动力学的变化,评价彩色多普勒超声检测甲状腺实质内血流分级的准确性,探讨甲状腺实质内血流分级、血流面积比(BCR)与甲状腺功能的相关性.方法 对43例临床确诊为Graves病患者,均行首次131 I治疗,治疗前均停用富碘食物及抗甲状腺药物,并行常规体检,检查甲状腺功能、最高吸碘率、有效半衰期,同时行二维超声、彩色多普勒血流显像检查,行甲状腺实质内血流分级及BCR,确定服131 I剂量并一次性给予.治疗后1、3、6个月行超声检查同时,检测甲状腺功能水平.结果 甲状腺实质内血流分级与BCR高度相关(r=0.805,P=0.000<0.05);二者分别在治疗前(r分别为0.262,0.324,P<0.05)、治疗后3个月(r分别为0.433,0.307,P<0.05)、治疗后6个月(r分别为0.612,0.473,P<0.05)与甲功水平存在相关性.结论 彩色多普勒血流分析对131 I治疗Graves病前后疗效评价具有重要的临床价值.%Objective To observe the change of ultrasound flow imaging before and after radioactive 131 I treatment Graves dis-ease, to test the accuracy of blood flow classification in thyroid parenchyma, and to compare the correlation of blood flow classifi-cation, blood flow area ratio to FT3 level. Methods 43 patients diagnosed with Graves disease first recieved radioactive 131 I treatment and they all stoped food which contained excess iodine and anti-thyroid drugs. The followings are carried out: regular physical examination, serological examination, effective half-life test, and color doppler flow imaging ( thyroid blood flow classifi-cation and blood flow area ratio);Then we determined 131 I dose and gave one-time. The ultrasonic index would be tested 1, 3, 6 months after treatment and serological examination shoud be processed at the same time. Results Blood flow classification of thy-roid parenchyma was obviously associated with thyroid blood flow area ( r =0. 805, P =0. 000);the two parameters were correla-ted with FT3 level before the treatment ( r =0. 262, P =0. 020;r =0. 324, P =0. 009), 3 months after treatment ( r =0. 433, P =0. 032;r =0. 307, P =0. 047), 6 months after treatment ( r =0. 612, P =0. 001;r =0. 473, P =0. 009). Conclusion Color Doppler ultrasound flow imaging has important clinical value before and after radioactive 131 I treatment of Graves disease.
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