graves病131i治疗后早发甲状腺功能减退症的可定量相关因素分析.docVIP

Graves病131I治疗后早发甲状腺功能减退症的可定量相关因素分析 　　【摘要】 目的：综合分析Graves病（GD）131I治疗后发生早发甲状腺功能减退症（甲减）的可定量相关因素。方法：根据国内外文献结合经验，制定GD131I治疗方案后，对93例GD经131I治疗患者的甲状腺质量、甲状腺自身抗体、最高摄碘率和2 h/24 h摄碘率比值、患者年龄、性别、病程、ATD治疗等因素与早发甲减进行单因素和多因素统计分析。结果：1年内随访的93例GD患者131I治疗后总治愈率为84.9%，总有效率为98.9%，早发甲减发生率为34.4%，GD131I治疗后早发甲低的单因素及多因素分析结果示全部自变量与早发甲减发生差异均无统计学意义（P0.05）。结论：GD131I治疗后发生早发甲减受许多可定量因素和不可定量因素的影响，而且各因素间彼此相互作用，所以制定个体化综合治疗方案时，结合患者的实际病情综合考虑，尽量控制可定量因素，尽可能降低早发甲减的发生率。 　　【关键词】 Graves病； 131I治疗； 甲状腺功能减退症； 因素分析 　　Analysis of Quantitative Influence Factors of Early Hypothyroidism in 131I Treatment of Graves Disease/JIN Yong-nan，TIAN Xing，HE Jian，et al.//Medical Innovation of China，2017，14（02）：113-117 　　【Abstract】 Objective：To explore the quantitative influence factors of early hypothyroidism（EH） in 131I treatment of Graves disease （GD）.Method：GD 131I treatment was based on international standards.93 cases of GD patients that were received 131I treatment were analyzed.Univariate andmultivariate statistical analysis were performed based on the age，sex，progress，ATD therapy，thyroid function and thyroid auto-antibodies.In addition，the highest iodine uptake rate and 2 h/24 h iodine uptake rate were also analyzed as contributing factors.Result：The overall surviving rate of 93 GD cases receiving 131I was 84.9%，the total responsive rate was 98.9%，and EH was 34.4%.There were no statistical differences between a variant（either single or multi） for the development of EH（P0.05）.Conclusion：The development of EH is controlled by many quantitative and un-quantitative factors，in which they might interact with each other.Therefore for a personalized medicine planning，it is beneficial to control quantitative factors to reduce the development of EH. 　　【Key words】 Graves disease； 131I therapy； Hypothyroidism； Factor analysis 　　First-author’s address：Jilin City People’s Hospital，Jilin 132001，China 　　doi：10.3969/j.issn.1674-4985.2017.02.029 　　131I治??Graves病（GD）以其简便、经济、安全、疗效佳、副作用小等优点已被越来越多的国内外医师和患者所接受。然而，131I治疗GD后的主要并发症甲状腺功能减退症（甲减