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目的:分析分化型甲状腺癌(DTC)患者n 131I治疗后体内放射性残留活度变化趋势及影响因素。n 方法:前瞻性收集2018年11月至2019年2月于天津医科大学总医院接受n 131I治疗的132例DTC患者[男34例，女98例，年龄(42.8±12.8)岁]的临床资料，患者分为首次治疗(FT)组(88例)和复次(n 131I治疗次数≥2次)治疗(RT)组(44例)。FT组中，清除残留甲状腺组织(简称清甲)30例、辅助治疗33例、清甲兼顾清除手术不能切除的DTC转移灶(简称清灶)25例；RT组中，清甲18例、清灶26例。n 131I治疗剂量：清甲3.70 GBq，辅助治疗3.70～5.55 GBq，清灶5.55～7.40 GBq。采用全身动态辐射监测系统测定患者n 131I治疗后24、48和72 h的体内放射性残留活度，比较组间差异。采用两独立样本n t检验、n χ2检验及二元logistic回归探讨放射性残留活度的影响因素。n 结果:FT组n 131I治疗后24 h体内放射性残留活度明显低于RT组[(880.60±396.64)和(1 022.31±503.94) MBq；n t＝-2.765，n P＝0.035]。FT组中，辅助＋清甲兼顾清灶亚组n 131I治疗后24、48 h的体内放射性残留活度高于清甲亚组[24 h：(987.16±447.33)和(766.27±277.87) MBq, 48 h: (233.47±146.52)和(183.52±90.65) MBq；n t值：-2.711和-2.021，均n P<0.05]。RT组中，清灶亚组n 131I治疗后24、48和72 h的体内放射性残留活度分别为(1 246.90±531.69)、(244.57±131.35)和(90.65±67.37) MBq，均高于清甲亚组[(715.50±300.07)、(149.85±68.82)和(58.46±31.45) MBq；n t值：-3.822～-2.682，均n P400 MBq，治疗后72 h所有患者体内放射性残留活度<400 MBq。T分期、N分期、刺激性甲状腺球蛋白(sTg)及n 131I治疗剂量影响体内放射性残留活度(n t值：-2.562～4.211, n χ2值：3.988～8.332，均n P<0.05)，其中T分期及n 131I治疗剂量是影响放射性残留活度的独立因素(n Walds值：4.253～14.035，均n P5.55 GBq)的患者，n 131I治疗后48 h残留活度可能不达标，隔离时间应延长至72 h。n “,”Objective:To analyze the trends and influencing factors of residual radioactivity in patients with differentiated thyroid carcinoma (DTC) after n 131I therapy.n Methods:A total of 132 DTC patients (34 males, 98 females; age (42.8±12.8) years) who received n 131I therapy from November 2018 to February 2019 in Tianjin Medical University General Hospital were prospectively analyzed. Patients were divided into first treatment (FT) group (n n=88) and repeat treatment (RT; with n 131I treatment≥2 times) group (n n=44). In FT group, there were 30 patients received n 131I for remnant ablation, 33 patients for adjuvant therapy and 25 patients for therapy. In RT group, there were 18 patients received n 131I for remnant ablation and 26 patients for therapy. n 131I dosage: 3.70 GBq for remnant ablation therapy, 3.70-5.55 GBq for adjuvant therapy, 5.55-7.40 GBq for therapy. The residual body radioactivity of patients was monitored at 24, 48 and 72 h after the administration of n 131I by dynamic radiation whole-body scanner and compared among groups. All clinical data were reviewed to explore the factors associated with the residual radioactivity. Independent-sample n t test, n χ2 test and logistic regression analysis were used to analyze the data.n Results:At 24 h after n 131I therapy, the residual radioactivity of patients in FT group were significantly lower than those in RT group ((880.60±396.64) n vs (1 022.31±503.94) MBq; n t=-2.765, n P=0.035). In FT group, the residual radioactivity of patients with n 131I adjuvant therapy+ therapy at 24 and 48 h after n 131I administration were higher than those with n 131I ablation (24 h: (987.16±447.33) n vs (766.27±277.87) MBq, 48 h: (233.47±146.52) n vs (183.52±90.65) MBq; n t values: -2.711 and -2.021, both n P<0.05). In RT group, the residual radioactivity of patients withn 131I therapy at 24, 48 and 72 h after n 131I administration were (1 246.90±531.69), (244.57±131.35) and (90.65±67.37) MBq respectively, which were higher than those with n 131I ablation ((715.50±300.07), (149.85±68.82) and (58.46±31.45) MBq; n t values: from -3.822 to -2.682, all n P400 MBq at 48 h aftern 131I treatment, and 100% (132/132) patients with residual radioactivity <400 MBq at 72 h after n 131I treatment. T staging, N staging, stimulated thyroglobulin level, andn 131I dosage were significant factors affecting the residual radioactivity of patients (n t values: from -2.562 to 4.211, n χ2 values: 3.988-8.332, all n P<0.05), and T staging andn 131I dosage were independent factors (n Walds values: 4.253-14.035, all n P5.55 GBq) may not reach the standard at 48 h aftern 131I therapy, and the isolation time should be extended to 72 h.n