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目的:探讨131I首次治疗甲状腺功能亢进症未愈及出现早发永久甲状腺功能低下的原因,提高131I治疗甲状腺功能亢进症的首次治愈率,降低早发永久甲状腺功能低下率。方法:回顾性分析131I首次治疗甲状腺功能亢进症235例患者的临床资料。结果:一次性痊愈129例(54.9%),未愈78例(33.2%),近期永久甲状腺功能低下28例(11.9%)。甲状腺质量>50g者131I首次痊愈率,近期永久甲状腺功能低下发生率低于甲状腺质量<30g者(P<0.01);最高甲状腺吸碘率>85%者131I首次痊愈率,近期永久甲状腺功能低下发生率低于最高甲状腺吸碘率<60%者(P<0.01);毒性结节性甲状腺肿者131I首次痊愈率,近期永久甲状腺功能低下发生率低于毒性弥漫性甲状腺肿者(P<0.01)。结论:甲状腺功能亢进症131I治疗剂量应根据患者甲状腺大小、最高甲状腺吸碘率、毒性结节性或毒性弥漫性甲状腺肿个体化给药。
Objective: To investigate the causes of 131I treatment of hyperthyroidism for the first time and the occurrence of premature permanent hypothyroidism, and to improve the first cure rate of 131I in the treatment of hyperthyroidism and reduce the rate of premature thyroid hypothyroidism. Methods: Retrospective analysis of 131I for the first time in the treatment of hyperthyroidism 235 cases of clinical data. Results: 129 cases (54.9%) were healed in one time, 78 cases (33.2%) were unhealed, and 28 cases (11.9%) had permanent thyroid dysfunction recently. Thyroid mass> 50g 131I first cure rate, the recent incidence of permanent hypothyroidism was lower than the thyroid mass <30g (P <0.01); highest thyroid iodine absorption rate> 85% 131I first cure rate, the recent permanent hypothyroidism occurred (P <0.01). The first cure rate of 131I in patients with toxic nodular goiter and the incidence of permanent permanent hypothyroidism in recent years were lower than that of diffuse diffuse goiter (P <0.01) . Conclusion: The dosage of 131I for hyperthyroidism should be administered individually according to thyroid size, iodine uptake rate in the highest thyroid, toxic nodular or diffuse goiter.