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目的 观察131I治疗Graves病的远期治疗效果。方法 随访 1989年 1月～ 1994年 12月间在本科行放射性131I治疗的 173例患者 ,并于 2 0 0 0年 1～ 3月复查血清FT3、FT4 、TSH。按131I治疗时患者的病程分为A(病程短于 1年 )、B(1～ 5年 )、C(6～ 2 0年 ) 3组。结果 (1)疗效 :173例患者一次治愈 15 6例 ,治愈率90 % ;未愈 17例 ,其中 11例接受第 2疗程治疗 ,9例治愈 ,第 2疗程治愈率为 82 %。 (2 )甲状腺机能减退 (甲减 )发生率 :复查时 ,一次治疗后共有甲减 16例 ,永久性甲减率为 9%。 (3)剂量 :平均每疗程131I剂量为 2 15 .93MBq(92 .5～ 4 0 7MBq) ,治愈组、未愈组和甲减组之间剂量无显著性差异 (P >0 .0 5 )。 (4)病程与疗效 :结果显示病程中等组 (1～ 5年 )疗效最佳 (87.5 % )。结论 131I对Graves病的远期疗效较佳 ,特别适于病程 1～ 5年的患者。
Objective To observe the long-term therapeutic effect of 131I on Graves disease. Methods A total of 173 patients treated with radioactive 131I from January 1989 to December 1994 were retrospectively studied. Serum FT3, FT4 and TSH were retrospectively reviewed from January to March in 2000. According to 131I treatment of patients with disease course is divided into A (duration of less than 1 year), B (1 ~ 5 years), C (6 ~ 20 years) 3 groups. Results (1) Efficacy: One hundred and seventy-seven patients were cured at one time, 15 6 cases, the cure rate was 90%; 17 cases were unhealed, of which 11 cases received the second course of treatment, 9 cases were cured, the second course of cure was 82%. (2) the incidence of hypothyroidism (hypothyroidism): review, a total of 16 cases of hypothyroidism, a permanent rate of 9% hypothyroidism. (3) Dose: The mean dose of 131I for every course was 2 1593MBq (92.5 ~ 4 0 7MBq). There was no significant difference in the dose between cured group, unhealed group and hypothyroidism group (P> 0.05) . (4) course of disease and efficacy: The results showed that the disease course of the best (1-5 years) the best effect (87.5%). Conclusion The long-term effect of 131I on Graves’ disease is better, especially for patients with disease course of 1 to 5 years.