刘少正 1胡杰群 2张庆 1陈庆杰 1阳正亚 1张青1
作者信息
- 1. 330006江西省南昌市,南昌大学第一附属医院核医学科
- 2. 330006江西省南昌市第三医院核医学科
- 折叠
摘要
Abstract
Objective To evaluate the clinical efficacy and associated factors of hypothyroidism produced by 131I combined with methimazole in treating Graves disease(GD).Methods We enrolled 2 428 cases of GD diagnosed based on the results of thyroid function test and clinical manifestations,and received treatment in the First Affiliated Hospital of Nanchang University and the Third Hospital of Nanchang during 2009—2015.Of whom,1 201 cases with contraindications to methimazole were treated only by 131I (group A) and other 1 227 cases without contraindications to methimazole were treated by 131I combined with methimazole (group B).The dosage of 131I for the patients varied according to age,courses of GD,status of iodine uptake,thyroid texture and thyroid weight,as well as the level of anti-thyroid antibodies.The outcome assessment was performed at least 12 months' follow-up.Results Group B achieved better outcome compared with group A (P<0.05) indicated by the following aspects: incidence of hypothyroidism〔300(24.45%) vs.538(44.80%)〕,partial remission rate〔142(11.57%) vs.38(3.16%)〕,complete remission rate[785(63.98%) vs.625(52.04%)].Multivariate Logistic regression analysis revealed that,131I dosage〔b=0.658,OR=1.931,95%CI(1.290,2.888)〕,thyroid weight〔b=-0.148,OR=0.862,95%CI(0.808,0.921)〕,131I conversion ratio〔b=0.058,OR=1.060,95%CI(1.020,1.101)〕and level of TPO 〔b=-1.188,OR=0.305,95%CI(0.104,0.896)〕 were the associated factors for hypothyroidism in patients with GD treated by 131I combined with methimazole(P<0.05).Conclusion Compared with methimazole alone,131I combined with methimazole for treating GD could decrease the risk of hyperthyroidism,but its efficacy can be affected by 131I dosage,thyroid weight,131I conversion ratio,and level of TPO.关键词
格雷夫斯病/131I/甲巯咪唑/甲状腺功能减退症/影响因素分析Key words
Graves disease/131I/Methimazole/Hypothyroidism/Root cause analysis分类
医药卫生
