摘要
目的 分析1 31 I治疗甲状腺功能亢进 (简称甲亢 )后早发甲状腺功能减退 (简称甲低 )的临床特点和远期随访结果。方法 对 14 5例1 31 I治疗甲亢后 1年内出现甲低的患者进行临床分析 ,并对其中 12 1例进行门诊长期随访 ,随访时间 1～ 12年 ,平均 5年。结果 ①暂发性甲低组 33例 ,占2 7 2 7% ,其中 1年内甲状腺功能恢复正常者 2 1例 ,又甲亢者 12例 ;远期随访显示 ,甲状腺功能正常者中有 2例在 5及 10年后出现甲低 ,甲亢者中有 3例在 3个月～ 5年甲状腺功能恢复正常 ,2例在 3个月及 6年后出现永久性甲低。②永久性甲低组 88例 ,占 72 73% ,其中 93 18% (82例 )在1 31 I治疗后 1～ 6个月出现甲低 ,有临床症状者占 86 36 % (76例 ) ,无临床症状者占 13 6 4 % (12例 ) ;服用小剂量1 31 I(≤ 185MBq)者占 82 95 % (73例 )。结论 早发甲低中 72 73%为永久性甲低 ,后者中服用小剂量1 31 I治疗者多。暂发性甲低的转归不能用于预测以后的甲状腺功能。
Objective To evaluate the clinical research and long-term follow-up results of early hypothyroidism after 131 I treatment for hyperthyroidism. Methods One hundred and forty-five patients with hyperthyroidism who developed hypothyroidism within 12 months after 131 I therapy were evaluated by clinical symptoms and plasma T_3,T_4,thyroid-stimulating hormone (TSH). One year after treatment,121 of 145 patients were divided into two groups according to the occurrence of hypothyroidism. Results ①Group 1: transient hypothyroidism (n=33),64%(21/33) of the patients developed euthyroidism and 36%(12/33) patients had recurrent hyperthyroidism within 1 year after being diagnosed with hypothyroidism after 131 I treatment. The long-term follow-up showed 2 patients were with euthyroidism and 2 patients who were previously with hyperthyroidism developed permanent hypothyroidism after 3 months～6 years. Three patients who were previously with hyperthyroidism developed euthyroidism after 3 months～5 years. Group 2: permanent hypothyroidism (n=88),82.95% (73/88) patients of group 2 were treated with low-dose 131 I,86.36% (76/88) cases of this group were found with clinical hypothyroidism. Conclusions 72.73% (88/121) patients of early hypothyroidism after 131 I therapy developed permanent hypothyroidism. The incidence of permanent hypothyroidism in the patients treated with low-dose 131 I was higher. Recovery of transient hypothyroidism after 131 I therapy did not predict future thyroid function.
出处
《中华核医学杂志》
CAS
CSCD
北大核心
2004年第4期245-246,共2页
Chinese Journal of Nuclear Medicine
