【摘要】 目的　为临床治疗甲状腺功能亢进症 (简称甲亢 )提供最佳131I剂量。方法　 138例弥漫性甲状腺肿并甲亢患者 ,131I治疗前后分别进行 2 4h甲状腺吸131I率 (TUR)和有效半衰期 (EHL)测量。示踪剂量的TUR(% ) =[(甲状腺部位计数 -本底计数 ) / (标准源计数 -本底计数 ) ]× 10 0 ;测量甲状腺部位计数下降一半的天数为EHL。治疗剂量的TUR(% ) =甲状腺部位的计数 / [131I标准源 (37MBq)计数×口服剂量 (MBq) ]× 10 0。所用仪器及工作条件一致 ,在准直器前置铅板和增大测量距离 ,减少治疗量计数 ,测EHL。治疗前后TUR和EHL分别进行t检验 ,治疗后随访 6个月以上 ,并按疗效分组进行比较。结果　示踪剂量TUR和EHL平均值均高于治疗剂量 (t =2 75 ,P <0 0 1;t =2 14,P <0 0 5 ) ,TUR差值平均为 (4 1± 8 9) % ,EHL(0 2 2± 0 73)d。早发甲状腺功能减退症 (简称甲低 )组与未愈组TUR差值差异有显著性 (t=2 0 7,P <0 0 5 ) ,而EHL差值差异无显著性。另有 6例治疗量吸收明显低下患者 ,重新计算补药后均达到治愈目的。结论　测量治疗量TUR和EHL有助于了解患者的131I实际吸收情况 ,预测疗效 ,对于治疗量吸收差的患者可及时补药 ;反之 ,要注意随访 ,避免早发甲低的漏诊。更多还原

【Abstract】 Objective To compare tracer and therapeutic activity kinetics of 131 I Method Thyroid Uptake Ratio (TUR) and Effective Half Life (EHL) measurements of tracer and therapeutic 131 I dose were performed on 138 patients Results The average values of tracer dose (0 074 MBq) TUR and EHL were higher than those of therapeutic dose (44 4～1 110 0 MBq) (t=2 75, P<0 01; t=2 14, P<0 05) The patients were followed up for more than 6 months after treatment, and the clinic outcomes were classified into 3 groups (A euthyroidism, B persistent or recurrent hyperthyroidism, C early hypothyroidism) Discrepancy of TUR between tracer and therapeutic dose in group B was larger than in group C (t=2 07, P<0 05), the discrepancy of EHL was not significant in 3 groups Another 6 patients’ TURs of therapeutic dose were much lower than that of tracer dose [(41 8±10 7)% vs (76 7±14 8)%],and after a supplementary dose of 131 I (73 4±31 0) MBq (calculated the dose again by absorbed TUR) they were cured and no early hypothyroidism occured Conclusions The TUR and EHL measurements after 131 I treatment can be helpful to study the actual absorbed dose in thyroid, and to predict the result of 131 I therapy; if the absorbed dose is low, a supplementary 131 I dose is needed to cure; and the attention should be paid to (early) hypothyroidism occurring更多还原