Study On The Individual-dose Of Radioiodine-131Therapy For Graves’ Disease

【Objective】1．To investigate the treatment effects of individual-dose radioiodine-131(¹³¹I)therapy for Graves’ diseaseï¼›2．To analysis the related factors affecting the treatment effects of individual-dose¹³¹I therapy for Graves’ diseaseï¼›3．To evaluate the outcome of hypothyroidism and the related factors after¹³¹Itherapyï¼›4．To explore the treatment effects of individual-dose¹³¹I therapy for thecomplications of Graves’ disease.【Methods】Four hundred and thirty one cases with Graves’ disease who acceptedindividual-dose¹³¹I therapy, were retrospectively studied, including115male and316female, aged from13to83years, average age was（38.32±12.34）years, course ofdisease from0to32years, average course was（4.52±3.26）years,177patients withhyperthyroid ophthalmopathy,35patients with hyperthyroid heart disease,82patientswith hyperthyroid liver damage,9patients with periodic paralysis.Graves’ diseasepatients were given individual-dose¹³¹I of mean （7.26±3.68） MBq per gram ofthyroid tissue.The term of follow-up was one year.Date including sex, age, course ofdisease, symptoms, signs, blood tests, mass of thyroid, texture of thyroid, radioactiveiodine uptake（RAIU） and dose of¹³¹I per gram of thyroid tissue were collected.Independent samples test, chi-square test, mann-whitney test and multi-variantlogistic regression were performed.【Results】1．There months after¹³¹I therapy,156patients（36.19%） were with well-healed,275 patients（63.81%） showed partially remitted or no changes,87patients（20.19%）suffered from early hypothyroidism. Six months after¹³¹I therapy,244patients（56.61%） were with well-healed,187patients（43.39%） showed partiallyremitted or no changes,197patients（45.71%） suffered from early hypothyroidism.Nine month after¹³¹I therapy,270patients（62.65%） were with well-healed,161patients（37.35%） showed partially remitted or no changes,189patients（43.85%）suffered from early hypothyroidism. One year after¹³¹I therapy,283patients（65.66%） were with well-healed,148patients（34.34%） showed partiallyremitted or no changes,184patients（42.69%） suffered from early hypothyroidism.2．Course of disease（Z=-2.434，P=0.015）, mass of thyroid（t=5.725，P＜0.001）,RAIU（t=2.431，P=0.015）, FT₃（t=3.990，P＜0.001）and dose of¹³¹I per gramof thyroid tissue（χ²=26.649，P＜0.001）were closely related to the outcome of¹³¹Itherapy by uni-variant analyses. Multi-variant logistic regression showed courseof disease（χ²=4.820，P=0.028）and dose of¹³¹I per gram of thyroid tissue（Wald=15.552，P＜0.001）were identified as independent impact factors affecting the¹³¹I treatment efficacy on Graves’ disease.3．Course of disease（χ²=6.431，P=0.040）, mass of thyroid（χ²=26.040，P=0.000）,TGAb and TPOAb（χ²=33.523，P＜0.001）, treated times of ATD（χ²=8.527，P=0.014）and dose of¹³¹I per gram of thyroid tissue（χ²=26.649，P＜0.001）wereimpact factors closely related to hypothyroidism by chi-square test.4．After¹³¹I therapy, of the177cases with hyperthyroid ophthalmopathy,67caseswere cured（37.85%）,56cases were improved（31.64%）,48cases were invalid（27.12%）,6case was aggravated（3.39%）; of the35cases with hyperthyroidheart disease,27cases were cured（77.14%）,8cases were improved（22.86%）;of the82cases with hyperthyroid liver damage,69cases were cured（84.15%）,13cases were improved（15.85%）; of the9cases with periodic paralysis,8caseswere cured（88.89%）,1case was improved（11.11%）.【Conclusions】1． The individual-dose¹³¹I therapy for Graves’ disease exerts good therapeuticefficienciesï¼› 2． Course of disease and dose of¹³¹I per gram of thyroid tissue are the independentimpact factors affecting the¹³¹I treatment efficacy on Graves’ diseaseï¼›3． After¹³¹I therapy, the hypothyroidism rate was higher. Course of disease, mass ofthyroid, TGAb and TPOAb, treated times of ATD and dose of¹³¹I per gram ofthyroid tissue were impact factors closely related to hypothyroidismï¼›4． The individual-dose¹³¹I therapy for the complications of Graves’ disease exertsgood therapeutic efficienciesï¼›5． All the impact factors should be comprehensively considered in individual-dose¹³¹I therapy for Graves’ disease so as to enhance the recovery rate and decreasethe hypothyroidism rate.