1回測定による有効半減期推定法を用いたバセドゥ病の甲状腺重量別~(131)I泊療成績

摘要

バセドゥ病の甲状腺重量別~(131)I治療において,伊藤病院ではl回の測定により有効半減期(EHL)を推定する方法(INDEX法)を見いだし,従来の,数回の測定によりEHLを求める方法(通常法)と並行して,主に外来患者の治療に用いてきた?このINDEX法と通常法とで,バセドゥ病の甲状腺重量別~(131)I治療を外来で受けた患者の治療5年目の成績を比較検討した.治療成績の評価は,治療後の甲状腺機能を低下,潜在性低下,正常,潜在性亢進,亢進に分類して行った。 その結果, 2方法でいずれの発生頻度にも有意差は認めなかった.INDEX法は,数回の測定によりEHLを求める通常法の半分の通院日数で,それと同等の治療成績を挙げることができ,優れた方法と思われた.In the determination of therapeutic ~(131)I doses, it takes several days to measure effective half life (EHL) of radioiodine in thyroid glands (Ordinary method). We suggested the new method to estimate EHL by a single radioiodine uptake measurement (INDEX method). We evaluated the outcome of ~(131)I treatment with these two methods in outpatients with Graves' disease. Eighty outpatients were treated with INDEX method (Group I) and 108 outpatients with Ordinary method (Group O). At the 5-yr follow up, the incidence of hypothyroidism in Group I was 22.5%, sub-clinical hypothyroidism 8.8%, euthyroidism 30.0%,subclinical hyperthyroidism 13.7% and hyperthyroid-ism 25.0%. In Group O, 17.6% of the patients were hypothyroid, 16.7% subclinical hypothyroid, 30.5% euthyroid, 9.3% subclinical hyperthyroid and 25.9% hyperthyroid. There were no significant differences between these two methods.We conclude that INDEX method surpasses Ordinary method in timesaver and is equal in effectiveness.