标题：131I联合 99Tc-MD治疗Graves眼病疗效观察

      作者：梁坤，李诗运，戴儒奇    (海南省人民医院核医学科，海南 海口 570311)

      卷次： 2017年28卷17期

      【摘要】 目的 探讨碘 131 (131I)联合锝亚甲基二膦酸盐注射液(99Tc-MD)治疗Graves眼病(GO)的临床效果。方法 回顾性分析2011年1月至2016年2月在海南省人民医院治疗的270例Graves眼病患者的临床资料，根据治疗方式将患者分为观察组(143例)和对照组(127例)。观察组采用 131I联合 99Tc-MD治疗，对照组仅使用 131I治疗，两组患者均规范治疗12个月，比较两组患者的甲亢及突眼的临床疗效。结果 观察组和对照组患者治疗甲亢总有效率分别为95.10%和86.62%，差异无统计学意义(P>0.05)；观察组和对照组患者治疗突眼总有效率分别为70.63%和41.73%，差异有统计学意义(P<0.05)，其中Ⅰ度有效率分别为92.86%和65.79%，Ⅱ度有效率分别为71.83%和34.92%，差异均有统计学意义(P<0.05)，Ⅲ度有效率分别为36.67%和23.08%，差异无统计学意义(P>0.05)；治疗后，观察组患者的突眼度、甲状腺容积分别为(17.78±2.42) mm、(25.79±3.23) g，明显小于对照组患者的(18.85±2.73) mm、(27.56±3.51) g，差异均有统计学意义(P<0.01)。两组患者均未现严重不良反应。结论 131I联合 99Tc-MD治疗Graves眼病，能提高患者的突眼治疗效果，改善患者的临床症状，值得临床参考。
      【关键词】 锝亚甲基二膦酸盐注射液；碘131；甲状腺亢进；突眼；治疗效果
      【中图分类号】 R771.3 【文献标识码】 A 【文章编号】 1003—6350（2017）17—2811—03

Clinical effect of 99Tc-MD combined with 131I in the treatment of Graves ophthalmopathy.
LIANG Kun, LI Shi-yun,Dai Ru-qi. Hainan Central Hospital, Haikou 570311, Hainan, CHINA
【Abstract】 Objective To explore the clinical effects of the Technetium Methylenediphosphonate Injection(99Tc-MD) combined with 131I in treatment of Graves ophthalmopathy (GO). Methods A total of 270 patients with GOin Hainan Central Hospital from Jan. 2011 to Feb. 2016 were randomly divided into the observation group (n=143) andthe control group (n=127), using random number table method. The observation group was treated with 131I combinedwith 99Tc-MD, while the control group was only treated with 131I. The clinical efficacy and treatment outcome of hyper-thyroidism and exophthalmos after standard treatment for 12 months were compared. Results There was no signifi-cant difference in the total efficiency between the observation group (95.10%) and the control group (86.62%), P>0.05.For exophthalmos, the total effective rate in the observation group (70.63%) was significantly higher than that in thecontrol group (41.73%), P<0.05. The Ⅰ grade effective rate was 92.86% in the observation group and 65.79% in thecontrol group (P<0.05), and the Ⅱ grade effective rate was 71.83% and 34.92%, respectively (P<0.05). There was nosignificant differences in the Ⅲ grade effective rate between the two groups (36.67% vs 23.08%, P>0.05). The exoph-thalmos degree and thyroid volume were (17.78±2.42) mm and (25.79±3.23) g in the observation group, which weresignificantly lower than (18.85±2.73) mm and (27.56±3.51) g in the control group (P<0.01). No adverse reactions wereobserved. Conclusion 131I combined with 99Tc-MD therapy in the treatment of Graves ophthalmopathy can increase theclinical efficacy, improve the clinical symptoms of the patients, which is recommended in clinical practice.
      【Key words】 99Tc-MD; 131I; Hyperthyroidism; Exophthalmos; Treatment outcome·论 著·doi:10.3969/j.issn.1003-6350.2017.17.019基金项目：海南省自然科学基金（编号：806117）