甲状腺癌病人131I治疗对唾液腺功能的影响

摘要

Salivary glands can accumulate 131I and may demage its function during 131I treated thyroid cancer. The purpose of this study is to understand the extent of the injury and its relation with dosage after high-dose radioiodine therapy. Radionuclide dynamic imaging is used to quantitatively calculate the absorption rate and excretion rate of salivary glands. There was no significant difference between patients group and normal controls in absorption rate (P>0.05), but there exieted difference in excretion rate (P<0.05). Absorption rate and excretion rate decreased as the therapy dosage increased and significant difference existed in the >37MBq group with dosage but among the groups with dosage <37MBq. Only the excretion rate had significant difference (P<0.05). Submandibular glands were less injuried comparing with parotid glands. Salivary glands function showed nearly normal or slightly injurled among young patients and those who received lower therapy dosage. It was concluded that quantitative radionuclide image can measure the absorption and excretion rate of salivary fland to reflect the function and injury extent. Therefore provided an evidence for clinical diagnosis. the injury extent was positively comelated to the dosage of 131I treatment.%甲状腺癌病人在接受碘-131治疗时,唾液腺也会浓聚131I而受到损伤。为了解大剂量131I治疗后,唾液腺损伤的程度以及与治疗剂量等方面的关系，用核素动态显像,定量计算唾液腺腺体的摄取率和排泄率。实验结果表明，全体病人组与正常人组相比较,摄取率没有显著性的差异(P>0.05),而排泄率两组均存在显著性的差异(P<0.05)。随着治疗累积剂量的增加,摄取率和排泄率也渐次降低,37GBq以上组别的结果与正常人相比,摄取率和排泄率均存在显著性的差异(P<0.05),37GBq以下各组仅排泄率上存在显著性差异(P<0.05)。颌下腺与腮腺相比较,颌下腺的受损程度较小。核素显像定量计算唾液腺摄取率和排泄率能反映腺体的功能及其受损程度,为临床诊疗提供一定的依据,接受131I剂量的大小与腮腺功能的影响程度呈正相关。