使用碘-131治療葛雷夫氏病后甲狀腺功能變化之追蹤報告

Follow-Up of Thyroid Function in Graves' Disease after Iodine-131 Therapy

王世楨(Shyh-Jen Wang) ； 林萬鈺(Wan-Yu Lin) ； 高嘉鴻(Chia-Hung Kao) ； 林佳輝(Jia-Huei Lin) ； 洪光威(Gang-Uei Hung) ； 許晉誠(Chin-Cheng Hsu)

《核子醫學雜誌》 13卷2期 (2000/06) Pp. 87-91

摘要

背景：使用放射性碘治療甲狀腺亢進已被公認為一項十分有效的方法，其優點在於使用方便、安全、便宜。然而使用此項治療法仍有一些問題存在：未能立即控制甲狀腺功能亢進的狀況及隨後而來的低甲狀腺功能。本回顧性研究分析過去幾年來葛雷夫氏病(Graves' disease)患者於本科接受碘-131治療的追踪結果。方法：本研究一共收集從1993到1997年於本科接受碘-131治療的117例葛雷夫氏病。這些病患皆因為內科治療失敗而轉介至本科接受碘-131治療。患者甲狀腺功能狀態的評估主要依靠臨床狀況及生化檢驗結果（包括血清T3、T4、TSH)。患者於治療後6個月接受評估，另一次較晚期的評估則於接受治療之後1年半進行。結果：我們的研究結果顯示在治療後6個月，有38例（33％）患者呈現低甲狀腺功能，25例（22％）患者呈現正常甲狀腺功能，54例（47％）患者呈現甲狀腺功能亢進。在治療後1年半，有36例（31％）患者呈现低甲狀腺功能，38例（33％）患者呈现正常甲狀腺功能，43例（37％）患者呈現甲狀腺功能亢進。結論：由我們的研究結果發现使用碘-131治療葛雷夫氏病發生低甲狀腺功能及再發甲狀腺功能亢進的情況相當多，所以對於使用碘-131治療葛雷夫氏病的患者必須給予密集的追踪並給予適當的處置。

關鍵字

甲狀腺功能亢進 ； 低甲狀腺功能 ； 碘-131 ； 放射性同位素治療

並列摘要

Background: Radioiodine therapy is an effective method of treating hyperthyroidism and has the advantage of safety, easy of administration, cheapness. The main problems associated with its use are delay in controlling hyperthyroidism and the ensuing high incidence of hypothyroidism. In this retrospective study, we tried to review the results of long-term follow-ups of patients with Graves' disease received 131I therapy in our hospital. Methods: This study includes 117 patients who underwent 131I therapy between 1993 and 1997.These patients were irresponsive to antithyroid during treatment. The thyroid function status was judged on the basis of clinical and biochemical features. Patients were evaluated at 6 months after therapy. Late follow-up were repeated(at least 1.5years after therapy).Results: Thyroid metabolism study on patients 6 months after last therapy showed 38 patients(33.3%)withhypothyroidism,25 patients(22%)with euthyroidism and 54 cases(47%)with hyperthyroidism. Late follow-up 1.5years after last therapy showed 36 patients(31%)with hypothyroidism,38 cases(33%)with euthyroidism and 43patients(37%)with hyperthyroidism. Conclusion: Our results revealed high incidence of hypothyroidism and recurrent hyperthyroidism after 131I therapy of Graves' disease. Close follow-up after 131I therapy is warranted.

並列關鍵字

hyperthyroidism ； hypothyroidism ； 131I ； radionuclide therapy