【摘要】 以长期随访方式观察碘-131治疗甲亢的疗效,并分析影响甲亢治愈和甲低发生的原因。对用碘-131治疗的甲亢患者进行随访的结果是:(1)碘-131治疗甲亢的总治愈率为74.4%,永久性甲低发生率7.5%。(2)男性与女性及初治与停用他巴唑>2周之间治愈率和甲低发生率差异无显著性(P>0.05)。(3)病程<1年、1―3年、>3年之间治愈率差异有显著意义(P<0.05),而甲低发生率无明显统计学差异(P>0.05)。(4)年龄<40岁与≥40岁及甲状腺大小<40g、40―55g、>55g之间治愈率和甲低发生率差异有显著意义(P<0.05)。(5)近期甲低和远期甲低的永久转化率分别为31.7%、76.9%;治疗时年龄较小的患者较易发生永久性甲低(P<0.05),而发生永久性甲低与不出现永久性甲低患者的甲状腺最高摄碘-131率之间差异无显著性(P>0.05)。由此得出以下结论:病程、年龄和甲状腺大小是影响甲亢治愈率的主要因素,而年龄和甲状腺大小是影响甲低发生率的主要因素。尽早碘-131治疗可提高疗效,同时应密切注意随访观察,警惕永久性甲低的发生。更多还原

【Abstract】 To investigate the therapeutic effect through long-term visit and analyze the affecting factors of cure rate after iodine-131 therapy for hyperthyroidism, a long-term follow-up has been undertaken for the patients with hyper- thyroidism after iodine-131 treatment. The following results have been obtained. (1)The cure rate of iodine-131 ther- apy for hyperthyroidism is 74.4%, and the incidence of permanent hypothyroidism is 7.5%. (2)There is no significant difference in the cure rate and incidence of hypothyroidism between the groups of male and female or “not take ATD” and “ATD withdrawn longer than 2 weeks” (P>0.05). (3) The difference of the cure rate among the groups of the courses of disease <1 a, 1―3 a and >3 a are significant (P<0.05), but there is no significance in the incidence of hy- pothyroidism. (4)The differences of the cure rate and the incidence of hypothyroidism between the groups of <40 a old and ≥40 a old or among the groups of thyroid mass <40g, 40―55g and >55g are significant (P<0.05). (5) The transferring rate of early hypothyroidism and late hypothyroidism to permanent hyothyroidism is 31.7% and 76.9% respectively. Permanent hypothyroidism easily happens for younger patients (P<0.05), but there is no difference in the peak uptake iodine-131 rate between patients with and without permanent hypothyroidism (P>0.05). The course of disease, age and thyroid mass are the major fators which influence the cure rate. Meanwhile, age and thyroid mass are the major fators which influence the incidence of hypothyroidism. To get high cure rate, the patients with hyperthy- roidism should be treated with iodine-131 as early as possible. In the meantime, the incidence of permanent hypothy- roidism must be paid attention to.更多还原