Changes in thyroid volume in response to radioactive iodine for Graves' hyperthyroidism correlated with activity of thyroid-stimulating antibody and treatment outcome.
Changes in thyroid volume in response to radioactive iodine for Graves' hyperthyroidism correlated with activity of thyroid-stimulating antibody and treatment outcome.
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格雷夫斯甲状腺功能亢进症放射性碘引起的甲状腺体积变化与甲状腺刺激抗体的活性和治疗结果相关。
DOI：
10.1210/jcem.81.9.8784079
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发表时间：
1996
期刊：
影响因子：
--
通讯作者：
N. Ohsawa
中科院分区：
文献类型：
--
作者：
Y. Murakami;J. Takamatsu;S. Sakane;K. Kuma;N. Ohsawa
本研究探讨了放射性碘(RAI)治疗Graves病时甲状腺体积与甲状腺功能的关系，以及血清中甲状腺相关免疫球蛋白(Ig)活性对甲状腺组织对RAI反应的影响。超声检查计算131I滞留在甲状腺组织中的每兆贝克勒尔甲状腺体积(MBq)的变化，作为RAI对甲状腺体积影响的定量指标。在接受131I治疗的52例患者中，26例在治疗后6个月出现甲状腺功能亢进，20例恢复正常，6例出现甲状腺功能低下。甲亢患者每MBq~(131)I的甲状腺体积变化低于正常或甲减患者(P<；0.01)。甲亢患者治疗前即刻血清甲状腺刺激性抗体活性高于甲减患者(P<0.667.0 1)，甲减患者高于甲减患者(P<0.0 5)，与甲状腺体积变化呈负相关(r=-0.0 5；P<0.0 1)。准确测量RAI治疗过程中甲状腺体积的变化为Graves病甲状腺组织对RAI的反应性提供了证据，这与甲状腺功能的结果有关。甲状腺刺激性抗体测定可能有助于确定获得正常甲状腺功能而不是甲状腺功能亢进的RAI的合适剂量。
This study investigated 1) the relationship between thyroid volume and thyroid function in radioactive iodine (RAI) treatment for Graves' disease, and 2) the activity of thyroid-related Ig in serum on the responsiveness of thyroid tissue to RAI. The changes in thyroid volume per megabecquerel (MBq) of 131I retained in thyroid tissue was calculated by ultrasonography as a quantitative indicator of the effect of RAI on thyroid volume. Of the 52 patients treated with 131I (3.7 MBq retained/g thyroid tissue), 26 patients showed thyrotoxicosis, 20 patients became euthyroid, and 6 patients developed hypothyroidism 6 months after therapy. The change in thyroid volume per MBq 131I was lower (P < 0.01) in the hyperthyroid patients than in the euthyroid or hypothyroid patients. The activity of thyroid-stimulating antibody in serum immediately before the therapy was greater (P < 0.01) in the hyperthyroid patients than in the euthyroid patients and was greater (P < 0.05) in the euthyroid patients than in the hypothyroid patients; it was inversely correlated with the changes in thyroid volume per MBq 131I (r = -0.667; P < 0.01). Accurate measurement of changes in thyroid volume during the course of RAI treatment provides evidence of the responsiveness of Graves' disease thyroid tissue to RAI, which is related to the outcome of thyroid function. Thyroid-stimulating antibody determination may be useful in deciding the appropriate dose of RAI to obtain euthyroidism instead of hyperthyroidism.