摘要:
目的 探讨放射性核素131I合并小剂量碳酸锂治疗Graves病的临床疗效。方法 治疗前口服碳酸锂250mg,1次/d,共5周。于第三周末给予Graves患者一次性口服131I,剂量为3.15MBq(80uCi)/g甲状腺组织的60%~70%。随访时间6~24个月(平均14个月),按随访结果分成痊愈、好转、无效三类。结果 单次131I合并小剂量碳酸锂治疗Graves患者,痊愈率(106例)、好转率(28例)、无效率(8例)分别为74.6%、19.7%、5.6%,对23例Graves患者进行重复治疗(未再次服用碳酸锂)后痊愈为10例、好转8例、无效5例,分别占43.5%、34.8%、21.7%。其中,首次131I治疗后半年随访为甲状腺功能减退症(简称甲减)者25例,占17.6%。结论 131I合并小剂量碳酸锂治疗Graves病疗效显著,同时可以减少131I的使用剂量,降低了药物的毒性反应。
Abstract:
Objective To investigate the clinical curative effects of 131I therapy combined with low-dose lithium carbonate for Graves disease.Methods Patients with Graves disease took lithium carbonate (250mg, once per day) orally for 5 weeks. Then they were treated with 131I (doses=3.15 MBq(80 uCi)/g, based on 60%~70% of the thyroid size). We kept track from 6 to 24 months (averaging 14 months) and classified the results into three:cured, improved or no effect.Results After a single cycle of 131I therapy combined with low-dose lithium carbonate, 106 patients with Graves disease were cured, 28 were improved and 8 saw no effects, respectively 74.6%,19.7% and 5.6% among the 142 patients. We then treated 23 of them with another 131I therapy (without lithium carbonate). 10 of such were cured (43.5%), 8 were improved (34.8%) and the other 5 saw no effects. Among all patients, hypothyroidism was observed from 25 (17.6%), 6 months after the first 131I therapy.Conclusions Notable curative results were observed from 131I therapy combined with low-dose lithium carbonate for Graves disease. Moreover, the dosage of 131I was therefore decreased, which also lowered the toxicity response.
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