Abstract
Objective To investigate the effects of using anti - thyroid drugs in advance on the cure time of patients with Graves disease who received 131 I radioactive therapy. Methods 129 cases of Graves disease who were treated in the First Affiliated Hospital of He′nan University of Science and Technology from January 2012 to March 2015,were selected as study subjects retrospectively,cases were in accordance with the inclusive criteria. Patients were divided into treatment group(72 cases,treated by anti - thyroid drugs) and untreated group(57 cases,not treated by anti - thyroid drugs) according to whether treated by anti - thyroid drugs before 131 I radioactive therapy. Patients in treatment group were divided into two subgroups based on the level of RAIU:high uptake rate treatment group(25 cases,RAIU > 30% )and middle uptake rate treatment group (47 cases,RAIU was 10% - 30% ). And patients in untreated group were also divided into two subgroups based on the level of RAIU:high uptake rate untreated group(19 cases)and middle uptake rate untreated group(38 cases)untreated. The date of treatment with 131 I radioactive was the start time point,cases were followed up for 1 year after treatment. The general information (gender,age,RAIU,dose of 131 I radioactive),cure rate,and cure time of patients were collected. The correlation between RAIU and cure time among treatment group and untreated group were analyzed by Pearson correlation analysis,respectively. The influencing factors for the cure time of Graves′ disease were analyzed by Cox proportional hazards regression model analysis,the Log - rank test was used to compare the cure time. Results The cure rate in high uptake rate treatment group,middle uptake rate treatment group,high uptake rate untreated group and middle uptake rate untreated group was 88. 0%(22 / 25),83. 0%(39 / 47),94. 7%(18 / 19)and 92. 1%(35 / 38)respectively. There were no significant differences in cure rate in four groups (χ2 = 2. 598,P = 0. 458). The cure time of high uptake rate treatment group,middle uptake rate treatment group,high uptake rate untreated group and middle uptake rate untreated group was(141 ± 7)d,(190 ± 9)d,(94 ± 6)d and(122 ± 6)d, respectively. The cure time of high uptake rate untreated group was significant shorter than that of high uptake rate treatment group (t = 23. 433,P < 0. 001),the cure time of middle uptake rate untreated group was significant shorter than that of middle uptake rate treatment group( t = 41. 609,P < 0. 001). The cure time was positive correlated to RAIU among treatment group( r= 0. 954,P < 0. 05,R2 = 0. 910)and untreated group(r = 0. 972,P < 0. 05,R2 = 0. 944),respectively. Using anti - thyroid drugs before 131 I radiocative therapy was the independent factor influencing the cure time of Graves′ disease〔RR = 0. 105,95%CI = (0. 062,0. 180),P < 0. 05〕,age〔 RR = 1. 163,95% CI = (0. 818,1. 655)〕,gender〔 RR = 1. 001,95% CI= (0. 970,1. 034)〕and RAIU〔RR = 0. 994,95% CI = (0. 972,1. 016)〕were not the independent factors influencing the cure time of Graves′ disease(P > 0. 05). There was significant difference in the cure time between high uptake rate treatment group and high uptake rate untreated group(χ2 = 7. 360,P < 0. 05),between middle uptake rate treatment group and middle uptake rate untreated group(χ2 = 8. 365,P < 0. 05). Conclusion Using anti - thyroid drugs before 131 I radioactive therapy can prolong the cure time of patients with Graves′ disease,patients with higher RAIU gain longer cure time.关键词
Graves 眼病/碘/抗甲状腺药/治疗结果Key words
Graves ophthalmopathy/Iodine/Antithyroid agents/Treatment outcome分类
医药卫生
