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目的:了解131Ⅰ治疗Graves病(GD)患者疗效的影响因素。方法:(1)接受131Ⅰ治疗的462例GD住院患者,年龄12～77岁,男141例,女321例。(2)按131Ⅰ治疗GD的流程进行甲状腺最高吸131Ⅰ率测定、甲状腺重量估算、甲状腺功能及相关抗体的血清学检查、131Ⅰ治疗前常规体检、有效半衰期测定、甲状腺ECT检查、131Ⅰ治疗剂量的确定、投予治疗剂量的131Ⅰ、随访安排及疗效评价。(3)对随访结果进行资料整理并统计计算。结果:(1)131Ⅰ治疗GD患者一次性治愈率为78.4%。(2)通过多因素分析,针对痊愈患者拟合的Logistic回归方程对痊愈患者判别的总准确性为79.5%。影响131Ⅰ治疗后疗效的因素有:GD患者年龄、甲状腺最高吸131Ⅰ率、有效半衰期、TG抗体。结论:甲状腺最高吸131Ⅰ率和有效半衰期为保护因子,患者年龄及TG抗体为危险因素。
Objective: To investigate the influencing factors of the therapeutic effect of 131 Ⅰ on Graves disease (GD). Methods: (1) 462 GD inpatients undergoing 131 Ⅰ treatment, aged from 12 to 77 years, 141 males and 321 females. (2) According to 131I treatment GD process, the thyroid uptake 131 I rate determination, thyroid weight estimation, thyroid function and related antibody serological examination, 131 I conventional examination before treatment, effective half-life, thyroid ECT examination, 131 I therapeutic dose determination , 131 I administered dose, follow-up arrangements and efficacy evaluation. (3) The follow-up results were analyzed and calculated. Results: (1) The 131 I treatment of GD patients with a one-time cure rate was 78.4%. (2) By multivariate analysis, the overall accuracy of Logistic regression equation fitting cured patients was 79.5%. The factors that influence the therapeutic effect after 131 Ⅰ treatment are as follows: the age of GD patients, the highest 131 Ⅰ rate of thyroid uptake, the effective half-life, and the TG antibody. Conclusion: The thyroid uptake rate of 131 Ⅰ and effective half-life as a protective factor, patient age and TG antibodies as risk factors.