The Relations Between The Thyroid-stimulating Hormone Receptor Antibody And Thyroid Weight As Well As The Early Outcomes After Radioiodine-131 Therapy Of Graves Disease

Objectives:To study the dynamics of the thyroid-stimulating hormone receptor antibody(TRAb) during one year with ¹³¹I and the relations of the weight of pre-treatment thyroid or the early outcomes with it in Graves' hyperthyroidism.Methods and Material:retrospectively study 193 patients with Graves' hyperthyroidism who had not been previously treated with radioactive iodine or subtotal thyroidectomy.Male:52;female:141.All patients between the age of 10-78 yr(average age:41.45±13.96yr) who referred to our depertment between April 2007 and August 2008.The titres of TRAb were determined once every three months before and after ¹³¹I therapy during 1yr.In term of the weight of thyroid,the patients were divided into 4 sub-groups(≤39g,39-48g,49-60g,≥61g).193 Subjects were followed for 6-20 months(average followed 10.37±2.87 months).According to the throid function and patients'clinical manifestation,the patients were divided into 3 groups:remission group with normal FT₃,FT₄.hyperthyroidism including:partial remission and hyperthyroid group with above normal levels of FT₃,FT₄.hypothyroid group with lowered levels of FT₃,FT₄.following terminal in Jun 2009.Respectively, compared the dynamic value of the sertum TRAb between the 4 weight-groups and 3 outcomes groups.All statistical analyses were performed by using the statistical SPSS for windows(version 11.5).Results:Prior to ¹³¹I treatment the TRAb was positive in 64.3%of the patients. After the therapy,the positive TRAb reached 92.0%,then slowly reduced after 6th month.Among the 4 differ goiter thyroid groups the dynamics of sertum TRAb didn't show any statistically differentia except the initial sertum TRAb(P=0.035).The effectiveness,however,in the 4 sub-groups has significant difference after iodine-131 treatment.Compared the dynamics of the serum TRAb in the 3rd month,6th month, 9th month,12th month among the 3 different outcomes groups,There is no statistical difference.In term of the 3 outcomes,remission group:51 persons(26.4%); hyperthyroidism:41 persons(21.2%);and hypothyroid:101 persons(52.3%).Prior to ¹³¹I treatment the serum TRAb,the The patients' age at ¹³¹I treatment,weight of pre-treatment thyroid,duration of disease,dosage of iodine-131 and Graves' ophthalmopathy have significant difference in the 3 outcomes sub-groups(P=0.033, P=0.010,P=0.000,P=0.002,P=0.019,P=0.001).Conclusion:1.After ¹³¹I therapy TRAb levels rosed transiently and reached the peak within 3-6 months and then dropped gradually thereafter.2.The difference of the thyroid weight did no influence to the change of the serum TRAb levels after ¹³¹I.3.The serum TRAb levels in 3rd month,6th month,9th month,12th month has no significant difference among the different outcomes groups.In the same time,the patients' age at ¹³¹I treatment,prior TRAb levels,thyroid weight,the Graves' ophthalmopathy,dosage of iodine-131 and duration of disease could be primary factors for successful remission.