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目的:筛选有利于延长n 131I有效半衰期的因素，为碳酸锂辅助放射性n 131I治疗甲状腺功能亢进症(简称甲亢)选择更合适的患者提供依据。n 方法:该前瞻性研究收集2017年7月至2019年3月间在郑州大学第一附属医院行n 131I治疗前进行碳酸锂辅助治疗的61例患者[男23例，女38例，年龄13～73(37.7±1.9)岁]。采用配对n t检验比较患者服用碳酸锂前后各临床参数[血清游离三碘甲状腺原氨酸(FTn 3)，血清游离甲状腺素(FTn 4)，2 h、4 h和24 h摄碘率，2 h/24 h和4 h/24 h摄碘率比值]的变化，采用简单线性回归和多重线性回归分析有利于延长n 131I有效半衰期的因素。n 结果:与治疗前相比，碳酸锂治疗后可显著提高24 h摄碘率[(74.82±2.69)%和(82.38±2.33)%；n t＝2.674, n P＝0.010]、降低4 h/24 h摄碘率比值[(88.96±2.85)%和(82.12±2.27)%；n t＝2.644, n P＝0.010]、延长n 131I有效半衰期[(123.03±3.09)和(130.38±2.49) h；n t＝2.656, n P＝0.010]及降低FTn 3[(26.46±1.65)和(21.31±1.42) pmol/L；n t＝3.421, n P＝0.001]和FTn 4[(56.59±2.12)和(49.24±2.19) pmol/L；n t＝3.289, n P＝0.002]。简单线性回归分析显示，2 h和4 h摄碘率、2 h/24 h和4 h/24 h摄碘率比值及治疗前n 131I有效半衰期与治疗后n 131I有效半衰期相关(n b值：-0.576～0.642，均n P<0.05)；多重线性回归分析显示，4 h/24 h摄碘率比值是影响碳酸锂治疗后n 131I有效半衰期变化的主要因素(n b＝0.642, 95% n CI：0.453～0.832，n P<0.001)。多重线性回归方程为n y＝-49.785+0.642n x，4 h/24 h摄碘率比值超过77.55%时服用碳酸锂治疗后可延长n 131I有效半衰期。n 结论:4 h/24 h摄碘率比值是影响碳酸锂治疗后n 131I有效半衰期变化的主要因素，且4 h/24 h摄碘率比值超过77.55%的甲亢患者服用碳酸锂治疗后可延长n 131I有效半衰期。n “,”Objective:To screen the factors that were conducive to prolonging the effective half-life of n 131I, and to provide a basis for selecting more suitable patients for the treatment of hyperthyroidism with lithium carbonate assisted radioactive n 131I.n Methods:Between July 2017 and March 2019, a total of 61 patients (23 males, 38 females, age: 13-73 (37.7±1.9) years) who received lithium carbonate adjuvant therapy before n 131I treatment in the First Affiliated Hospital of Zhengzhou University were collected into this prospective study. Clinical parameters (serum free triiodothyronine (FTn 3), serum free thyroxine (FTn 4), iodine uptake rate (2 h, 12 h, 24 h) and ratio of iodine uptake rate (2 h/24 h, 4 h/24 h) before and after taking lithium carbonate were compared by using paired n t test. The factors which were conducive to prolonging the effective half-life of n 131I were analyzed by linear and multiple regression analyses.n Results:Compared with the pretreatment results, lithium carbonate treatment significantly improved the 24 h iodine uptake rate ((74.82±2.69)% n vs (82.38±2.33)%; n t=2.674, n P=0.010), decreased the ratio of 4 h/24 h iodine uptake rate ((88.96±2.85)% n vs (82.12±2.27)%; n t=2.644, n P=0.010), prolonged the effective half-life of n 131I ((123.03±3.09) n vs (130.38±2.49) h; n t=2.656, n P=0.010), and decreased serum FTn 3 ((26.46±1.65) n vs (21.31±1.42) pmol/L; n t=3.421, n P=0.001) and serum FTn 4 ((56.59±2.12) n vs (49.24±2.19) pmol/L; n t=3.289, n P=0.002). Linear regression analysis showed that 2 h and 4 h iodine uptake rate, the ratios of 2 h/24 h and 4 h/24 h iodine uptake rate, and effective half-life of n 131I before lithium carbonate treatment were related to the effective half-life of n 131I after lithium carbonate treatment (n b values: from -0.576 to 0.642, all n P<0.05). Multiple linear regression analysis showed that the ratio of 4 h/24 h iodine uptake rate was the main factor affecting the effective half-life ofn 131I after taking lithium carbonate (n b=0.642, 95% n CI: 0.453-0.832, n P<0.001). Multiple linear regression equation wasn y=-49.785+ 0.642n x. Lithium carbonate treatment could prolong the effective half-life of n 131I if the ratio of 4 h/24 h iodine uptake exceeded 77.55%.n Conclusion:The ratio of 4 h/24 h iodine uptake rate is the main factor affecting the change of the effective half-life of n 131I after lithium carbonate treatment, and patients with hyperthyroidism whose ratio of 4 h/24 h iodine uptake rate exceeds 77.55% can effectively prolong the effective half-life of n 131I after taking lithium carbonate.n