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目的探讨纳入有效半减期计算投入剂量对~(131)I治疗Graves’甲亢(Graves disease,GD)转归的影响。方法收集本科2014年9月至2016年4月就诊患者中符合~(131)I治疗并同意采用该治疗的GD患者201例,采用抛币法分为对照组(n=79)和观察组(n=122)。测定所有患者2、4、24、48 h的甲状腺吸碘率,利用公式y=-4.555 1x+0.169 3计算有效半减期,观察组将有效半减期纳入公式计算投入剂量,对照组采用通用的计量法计算投入剂量,观察两组投入剂量、甲亢一次性缓解率、早发甲减率的差异。结果分别按观察组与对照组公式计算每位患者的投入剂量,观察组平均投入剂量较对照组减少1.46 mci(t=25.61,P<0.01);观察组与对照组一次性缓解率分别为94.93%、91.80%,两组差异有统计学意义(P>0.05);观察组早发甲减率为9.01%,显著低于对照组的16.46%(P<0.01);有效半减期≥6.0 d时,对照组早发甲减率62.5%,显著高于观察组的22.22%(P<0.01)。两组有效半减期在3.9~<4.5 d时,平均缓解率78.57%;4.5~<6.0 d时,平均缓解率94.11%;≥6.0 d时平均缓解率为96.15%。随着有效半减期的延长,平均缓解率逐渐增加(P<0.01)。结论基于个体有效半减期计算~(131)I投入量可减少治疗GD的投入剂量并提高一次性缓解率和降低早发甲减率。
Objective To investigate the effect of the dose of 131I treatment on the outcome of Graves’ disease (GD) calculated by effective half-life reduction. Methods Totally 201 patients with GD who met the treatment of ~ (131) I and received treatment from September 2014 to April 2016 were divided into control group (n = 79) and observation group (n = n = 122). The iodine uptake rate of thyroid in all patients was measured at 2, 4, 24, and 48 h, the effective half-period was calculated by the formula y = -4.555 1x + 0.169 3, the effective half-period of observation group was calculated into the formula, Dose method to calculate the dose, the observed dose of two groups, one-time response rate of hyperthyroidism, early hair hypothyroidism rate differences. Results The dosage of each patient was calculated according to the formula of observation group and control group respectively. The average dose of observation group was 1.46 mci less than that of control group (t = 25.61, P <0.01). The one-time remission rates of observation group and control group were 94.93 % And 91.80%, respectively. The difference between the two groups was statistically significant (P> 0.05). The rate of early hypothyroidism in the observation group was 9.01%, significantly lower than that in the control group (16.46%, P <0.01) , The rate of early hypothyroidism was 62.5% in the control group, which was significantly higher than that in the observation group (22.22%, P <0.01). The effective half-period between two groups was 3.9 ~ <4.5 d, with an average response rate of 78.57%. At 4.5 ~ <6.0 d, the average response rate was 94.11%. The mean remission rate at 96.0% was 96.15%. With the effective half-life extension, the average response rate increased gradually (P <0.01). Conclusions The calculation of ~ (131) I dosage based on effective half-life of individuals can reduce the dose of GD and improve the one-time remission rate and reduce the incidence of early hypothyroidism.