Graves病~(131)I治疗中甲状腺CT和SPECT两种不同测重方法疗效对比评价

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目的通过甲状腺CT和SPECT两种不同测重方法对Graves病131I疗效进行对比评价,探讨最佳测重方法。方法 Graves病患者220例,(1)按就诊时间先后顺序,设定第一时间阶段患者应用CT行甲状腺测重,为第一组(n=95);设定第二时间阶段患者应用SPECT行甲状腺测重,为第二组(n=125)。(2)严格控制任何对检查结果和131I疗效有影响的因素。(3)设定检查程序、设定对照组和疗效判断标准。分别对两组测重结果及疗效进行统计学分析处理。结果甲状腺不同测重方法结果比较:(1)甲状腺CT测重组与对照组比较,当甲状腺重量<30 g,与对照组比较差异无统计学意义(χ2=0.11,P>0.05);当甲状腺重量>30 g,其差异均有统计学意义(χ2=5.40、6.45,P<0.05)。(2)甲状腺SPECT测重组与视触测重方法对比观察,各组与对照组比较,其差异均有统计学意义(χ2=4.99、4.09、20.93,P<0.05),尤其甲状腺重量>70 g时,其差异有显著统计学意义。两组疗效比较:(1)总有效率和一次治愈率,甲状腺CT测重组明显高于SPECT测重组,其差异有显著统计学意义(χ2=28.13、28.70,P<0.05)。(2)好转率和甲状腺功能减低发生率,两组比较其差异无统计学意义(χ2=0.40、1.00,P>0.05)。(3)无效率和复治率,甲状腺CT测重组明显低于SPECT测重组,其差异均有显著统计学意义(χ2=26.71、52.80,P<0.05)。结论应用甲状腺CT断层测重法,其结果更接近甲状腺实际重量。可提高Graves病131I一次治愈率。 Objective To evaluate the therapeutic effect of 131I on Graves’ disease by two different methods of CT and SPECT. Methods 220 patients with Graves disease, (1) according to the order of treatment time, set the first time period patients using CT line thyroid weight measurement, the first group (n = 95); set the second time period patients with SPECT line Thyroid weights were measured for the second group (n = 125). (2) Strict control of any factors that have an impact on test results and 131I efficacy. (3) set the inspection process, set the control group and efficacy criteria. Respectively, the results of two groups and the curative effect of statistical analysis. Results Thyroid gland weight measurement method compared the results: (1) thyroid CT weight measurement group compared with the control group, when the thyroid weight <30 g, compared with the control group no significant difference (χ2 = 0.11, P> 0.05); when the thyroid weight > 30 g, the difference was statistically significant (χ2 = 5.40,6.45, P <0.05). (2) The comparison between thyroid SPECT and visual acuity gravimetric methods showed that the difference between the two groups was statistically significant (χ2 = 4.99,4.09,20.93, P <0.05), especially thyroid weight> 70 g When the difference was statistically significant. Comparison of curative effect between the two groups: (1) The total effective rate and primary cure rate, thyroid CT test group was significantly higher than the SPECT test group, the difference was statistically significant (χ2 = 28.13,28.70, P <0.05). (2) Rate of improvement and the incidence of hypothyroidism, there was no significant difference between the two groups (χ2 = 0.40, 1.00, P> 0.05). (3) The inefficiency and recuperation rate, thyroid CT weight measurement group was significantly lower than SPECT weight measurement group, the difference was statistically significant (χ2 = 26.71,52.80, P <0.05). Conclusion Thyroid CT gravimetric method, the results closer to the actual thyroid weight. Graves disease can improve the cure rate of 131I.
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