Analysis of thyroid iodine uptake rate and 99Tc m imaging in the treatment of Graves hyperthyroidism with 131I
10.3760/cma.j.cn431274-20200630-00897
- VernacularTitle:甲状腺摄碘率和 99Tc m显像对Graves甲亢 131I治疗疗效的分析
- Author:
Yifan CHEN
1
;
Yuchun ZHU
;
Wei ZHOU
;
Qing ZHOU
;
Jing WANG
;
Dan DU
Author Information
1. 江苏大学医学院，镇江 212013
- Keywords:
Graves disease;
Hyperthyroidism;
Thyroid iodine uptake rate;
99Tc m imaging;
131I therapy;
Thyroid hormone
- From:
Journal of Chinese Physician
2021;23(10):1528-1532,1537
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the relationship between thyroid iodine uptake rate, 99Tc m imaging and treatment of Graves' hyperthyroidism with 131I. Methods:132 patients with Graves' hyperthyroidism were analyzed retrospectively. According to the difference of thyroid 24-hour iodine uptake rate, they were divided into group A (≤50%), group B (50%-80%) and group C (≥80%). According to the trend of iodine uptake rate curve, they were divided into peak advance group (6 h/24 h iodine uptake rate ratio >1) and non-peak advance group (6 h/24 h iodine uptake rate ratio≤1). Thyroid 99Tc m imaging was divided into three groups according to quality, including group 1 (≤30 g), group 2 (30-60 g) and group 3 (≥60 g). The therapeutic effects of 131I in different types of patients were compared. Results:132 patients were followed up for 6 months after the first 131I treatment. The total effective rate, total cure rate and uncured rate were 88.6%(117/132), 78.0%(103/132), 22.0%(29/132), respectively. The serum thyroxine levels of patients with different 24-h iodine uptake rates in the three groups after treatment were significantly lower than those before treatment ( P<0.05). The lower the 24-h iodine uptake rate of thyroid, the more significantly the serum total triiodothyronine (TT3), total triiodothyronine (TT4), free triiodothyronine (FT3) and free thyroxine (FT4) levels decreased after treatment, the more obvious the increase of thyroid stimulating hormone (TSH), and the more obvious the treatment effect ( P<0.05). The cure rate (13/29, 44.8%) in the peak advance group was significantly lower than that in the non peak advance group (90/103, 87.4%), with statistically significant difference (χ 2=23.899, P<0.001). There was significant difference in the cure rate among the three groups with different thyroid 99Tc m imaging quality (χ 2=15.502, P<0.001). Conclusions:With the increase of thyroid mass, the higher the 24-h iodine intake rate, the more obvious the peak shift, the lower the cure rate, the higher the non-healing rate, and the lower the incidence of hypothyroidism.
