预测甲状腺功能亢进患者接受低剂量 I-131 治疗后病情缓解的因素:一家三级甲等医院的 20 年回顾性研究。

IF 2.5 4区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Shrinivas Yuvan S, Subramanyam Padma, Palaniswamy Shanmuga Sundaram
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引用次数: 0

摘要

目的评估南印度一家三级医院接受低剂量 I-131(放射性碘)治疗的甲亢患者的疗效和预测缓解的因素:这项为期 20 年的单一机构回顾性研究针对 3891 名成年甲亢患者展开。只对有完整临床记录的患者进行了审核。研究分析了2000年3月至2020年期间在科钦阿姆利塔研究所接受低剂量I-131治疗(LDT)的患者记录。统计分析采用 SPSS 10 软件:结果:分析了 3891 名甲状腺功能亢进症患者的记录,其中女性患者居多。65%的患者患有GD,33%患有TMNG,3%患有ATN。在服用单剂量 LDT 后,最早在 12 周内(61% 的患者)就出现了较高的缓解率,同时在服用 LDT 前的 3-4 周内严格执行无碘饮食。研究显示,那些游离 T4(fT4)较低、甲状腺肿小(甲状腺体积 3)的患者,结论是:单剂量 LDT 治疗的疗效较高:在无碘饮食期间,单剂量 LDT 的治疗效果很好。90%的患者在服用单剂量 LDT 5 个月后病情得到缓解。其中 56% 的患者在接受 LDT 治疗前没有接受过治疗。因此,LDT对甲状腺功能亢进患者是一种安全有效的治疗方法,可推荐作为主要的治疗方式。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Factors predicting remission in hyperthyroid patients after low-dose I-131 therapy: 20 years retrospective study from a tertiary care hospital

Factors predicting remission in hyperthyroid patients after low-dose I-131 therapy: 20 years retrospective study from a tertiary care hospital

Objective

To assess the therapeutic outcome and factors predicting remission in hyperthyroid patients treated with low-dose I-131 (radioactive iodine) from a tertiary care hospital in South India.

Methods

This 20-year single-institutional retrospective study was carried out on 3891 hyperthyroid adult patients. Only those patients with complete clinical records were audited. Selection criteria were based on patients with scintigraphic diagnosis of either Graves’ disease (GD), toxic multinodular goitre (TMNG) or autonomous toxic nodule (ATN) and the records of those who received low-dose I-131 therapy (LDT) between March 2000 and 2020 at Amrita Institute, Cochin were analysed. SPSS 10 software was used for statistical analysis.

Results

The records of 3891 hyperthyroid predominantly female patients were analysed. 65% patients had GD, 33% had TMNG and 3% were ATN. High rates of remission as early as 12 weeks (in 61% patients) was observed with a single dose of LDT while on strict iodine-free diet for 3–4 weeks prior to LDT. Study reveals that those with lower free T4 (fT4), small goitre (thyroid volume < 25 cm3), < 15% thyroid trapping function, shorter time duration from onset of hyperthyroidism to LDT, and treatment-naïve patients were factors determining high remission rates. Mann Whitney U test and Chi-square test was used to correlate variables in the remission and relapse groups. We found a positive correlation between fT4, thyroid volume (r = 0.35, p < 0.01) and trapping function (r = 0.34, p < 0.01), which were independent of age, sex, body mass index and TSH levels in our study.

Conclusion

High therapeutic outcome was observed with a single dose of LDT while on iodine-free diet. Remission with single dose of LDT occurred in 90% patients by 5th month. Of them 56% patients were treatment naive prior to LDT. LDT is thus a safe and effective therapy in hyperthyroid patients and can be recommended as a primary modality of management.

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来源期刊
Annals of Nuclear Medicine
Annals of Nuclear Medicine 医学-核医学
CiteScore
4.90
自引率
7.70%
发文量
111
审稿时长
4-8 weeks
期刊介绍: Annals of Nuclear Medicine is an official journal of the Japanese Society of Nuclear Medicine. It develops the appropriate application of radioactive substances and stable nuclides in the field of medicine. The journal promotes the exchange of ideas and information and research in nuclear medicine and includes the medical application of radionuclides and related subjects. It presents original articles, short communications, reviews and letters to the editor.
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