标题：131I治疗巨大甲状腺肿性Graves病104例临床分析

      作者：赵小艳，陈再君，罗茂香，许先华
    (南华大学附属南华医院核医学科，湖南 衡阳 421002)

      卷次： 2013年24卷4期

      【摘要】 目的 评价 131I治疗巨大甲状腺肿性Graves病的治疗效果和 131I使用剂量的最优化。方法 经过
131I治疗 104例巨大甲状腺肿性Graves病患者，依据 SPECT甲状腺断层显像确定甲状腺质量为 70~200 g，平均
(93.2±27.5) g，根据患者个体因素确定个体化的每克甲状腺组织 131I剂量，一般每克甲状腺 131I剂量范围为 3.7~
7.77 MBq，给予的 131I治疗剂量范围为 518~1 369 MBq。结果 一次 131I治疗后，60例(57.7%)甲状腺功能恢复正
常，30例(28.9%)大部分缓解，8例(7.7%)部分缓解，4例(3.8%)甲减，仅2例(1.9%)无效，且无效的2例患者经第2次
131I治疗后都明显缓解。结论 131I治疗巨大甲状腺肿性Graves病是一种安全有效的方法；依据甲状腺断层显像
确定甲状腺质量和根据患者个体情况确定个体化的每克甲状腺组织 131I剂量可以优化 131I治疗效果。

      【关键词】 131I治疗；Graves病；巨大甲状腺肿

      【中图分类号】 R581.3 【文献标识码】 A 【文章编号】 1003—6350（2013）04—0493—02


Clinical effect of 131 I treatment for 104 cases of hyperthyroidism of Graves' disease.
ZHAO Xiao-yan, CHEN
Zai-jun, LUO Mao-xiang, XU Xian-hua, LI Wei. Department of Nuclear Medicine, the Affiliated Nanhua Hospital of
Nanhua University, Hengyang 421002, Hunan, CHINA

【Abstract】 Objective To evaluate the clinical effect of 131I treatment for hyperthyroidism of Graves' disease, and to
optimize the doses of 131I. Methods One hundred and four patients with hyperthyroidism of Graves' disease received 131I
treatment. The quality of thyroid was determined to be 70~200 g [(93.2±27.5) g in average] based on SPECT. The dose of 131I
was applied according to the individual factors of patients, normally 3.7~7.77 MBq 131I per gram of thyroid. The range of the
therapeutic dose of 131I was 518~1 369 MBq. Results After 131I treatment, 60 patients (57.7%) had thyroid function returned
to normal, 30 patients (28.9%) achieved most response, 8 patients (7.7%) achieved partial response, 4 patients (3.8%) suffered
hypothyroidism, and 2 patients (1.9%) showed no response. The 2 patients achieved obvious response after the second 131I
treatment. Conclusion 131I treatment is safe and effective for hyperthyroidism of Graves’disease. To optimize the therapeu-
tic effect, the dose of 131I should be determined according to the quality of thyroid and the individual factors of patients.