论文部分内容阅读
目的 为临床治疗甲状腺功能亢进症 (简称甲亢 )提供最佳131I剂量。方法 138例弥漫性甲状腺肿并甲亢患者 ,131I治疗前后分别进行 2 4h甲状腺吸131I率 (TUR)和有效半衰期 (EHL)测量。示踪剂量的TUR(% ) =[(甲状腺部位计数 -本底计数 ) / (标准源计数 -本底计数 ) ]× 10 0 ;测量甲状腺部位计数下降一半的天数为EHL。治疗剂量的TUR(% ) =甲状腺部位的计数 / [131I标准源 (37MBq)计数×口服剂量 (MBq) ]× 10 0。所用仪器及工作条件一致 ,在准直器前置铅板和增大测量距离 ,减少治疗量计数 ,测EHL。治疗前后TUR和EHL分别进行t检验 ,治疗后随访 6个月以上 ,并按疗效分组进行比较。结果 示踪剂量TUR和EHL平均值均高于治疗剂量 (t =2 75 ,P <0 0 1;t =2 14,P <0 0 5 ) ,TUR差值平均为 (4 1± 8 9) % ,EHL(0 2 2± 0 73)d。早发甲状腺功能减退症 (简称甲低 )组与未愈组TUR差值差异有显著性 (t=2 0 7,P <0 0 5 ) ,而EHL差值差异无显著性。另有 6例治疗量吸收明显低下患者 ,重新计算补药后均达到治愈目的。结论 测量治疗量TUR和EHL有助于了解患者的131I实际吸收情况 ,预测疗效 ,对于治疗量吸收差的患者可及时补药 ;反之 ,要注意随访 ,避免早发甲低的漏诊。
The purpose of clinical treatment of hyperthyroidism (referred to as hyperthyroidism) to provide the best 131I dose. Methods Thirty-eight patients with diffuse goiter and hyperthyroidism were enrolled in this study. Thyroid 131I (TUR) and effective half-life (EHL) were measured before and after 131I treatment. TUR (%) of tracer dose = [(Thyroid site count - background count) / (standard source count - background count)] × 10 0; the number of days when the thyroid site count was halved was EHL. TUR (%) of therapeutic dose = count of thyroid gland / [count of 131I standard source (37 MBq) × oral dose (MBq)] × 10 0. The instruments used and the working conditions are the same, before placing the lead plate in the collimator and increasing the measuring distance, reducing the treatment volume counting, measuring EHL. Before and after treatment TUR and EHL were t test, follow-up after 6 months of treatment, and according to the efficacy of subgroups for comparison. Results Tracer dose TUR and EHL average were higher than the therapeutic dose (t = 2 75, P <0.01; t = 2 14, P <0 0 5), TUR difference was (4 1 ± 8 9) %, EHL (0 2 2 ± 0 73) d. There was a significant difference in TUR between early hypothyroidism (hypothyroidism group) and unhealed (t = 2 0 7, P <0 05), while there was no significant difference in EHL difference. Another 6 cases of patients with significantly lower absorption of treatment, recalculated after tonic to achieve the purpose of cure. Conclusion The measurement of TUR and EHL can help to understand the actual 131I absorption of patients and predict the curative effect. Patients who have poor absorption of treatment can be given supplements in time. On the other hand, follow-up should be paid attention to to avoid missed diagnosis of early hypothyroidism.