| Objective:Radioactive iodine therapy is widely used in the treatment of Graves'disease,and the therapeutic efficacy of radioactive iodine therapy is individual differences.The 131? metabolism rate of thyroid tissue is one important indicators factor of the therapeutic efficacy of radioactive iodine therapy,and iodine turnover rate is an important index reflecting the 131? metabolism rate of thyroid tissue.The predict value of iodine turnover rate in radioactive iodine therapy is not yet clear,the purpose of this paper is to explore the correlation between iodine turnover rate and the therapeutic efficacy of radioactive iodine therapy.Methods:Retrospectively collected and analyzed Graves'disease person who had received radioactive iodine therapy in the Nuclear Medicine First Affiliated Hospital of China Medical University between September 2016 and December 2017,all patients had undergone iodine metabolic experiment before radioactive iodine therapy,and calculated iodine turnover rate,and gave patients treatment dose of131?,and did follow-up by outpatient service and telephone after therapy?follow-up time?3months?.The clinical outcome of each patient was evaluated,and patients were divided into 2 groups:cure group and unrecovered group.Based on iodine turnover rate,patients were divided into four groups:the first group iodine turnover rate?0.5,the second group 0.5<iodine turnover rate?0.7,the third group 0.7<iodine turnover rate?0.9,the fourth group iodine turnover rate>0.9,and analyse the difference of the cure rate between four groups by Chi-square test.Compare the clinical characteristics date(include age,gender,duration,serological indexes,24h radioactive iodine uptake rate,history of radioactive iodine therapy,history of anti-thyroid drug treatment,thyroid weight,unit 131? treatment dose by thyroid tissue)and iodine turnover rate between cure group and unrecovered group by Mann-Whitney test,and then these factors with statistical differences were analyzed by multivariate analysis method.Results:In this study,a total of 536 Graves'disease patients were collected which meet the conditions and have complete information,there were 125?23.3%?men,411?76.7%?women,with the mean age was 42.27±13.49 years old.According to the evaluation standard of 2013 China Guidelines for Radioactive Iodine Therapy in Graves'disease,there were 306?57.09%?patients in cure group,and 230?42.91%?patients in unrecovered group.The cure rate of four group were 74.70%?62/83?,62.76%?150/239?,44.12%?75/170?,43.18%?19/44?,Chi-square test result shows that there are relationship between the iodine turnover rate and cure rate?X2=28.796,p<0.001?.The univariate analysis showed that,between cure group and unrecovered group,gender?Z=-0.075,P=0.941?,24h radioactive iodine uptake rate?Z=1.84,P=0.066?,the history of iodine treatment?Z=-0.268,P=0.788?were not statistical differences,which there were statistically differences in age?Z=-3.15,P=0.002?,free triiodothyronine?FT3??Z=3.17,P=0.002?,free thyroxine?FT4??Z=2.11,P=0.035?,the duration of the disease?Z=2.59,P=0.01?,the history of medication?Z=2.53,P=0.011?,the weight of the thyroid gland?Z=8.57,P<0.001?,iodine turnover rate?Z=5.98,P<0.001?,unit of thyroid tissue treatment dose?Z=-6.05,P<0.001?.And multivariate analysis showed that thyroid weight?P<0.001?,iodine turnover rate?P<0.001?,unit of thyroid tissue treatment dose?P=0.022?are the independent influencing factors of therapeutic efficacy of radioactive iodine therapy,logit?P?=2.716-0.039*thyroid weight+0.233*unit of thyroid tissue treatment dose-2.741*iodine turnover rate.Conclusions:Iodine turnover rate is independent influencing factor of therapeutic efficacy of radioactive iodine therapy,there was a negative correlation between the iodine turnover rate and the therapeutic efficacy of radioactive iodine therapy,and it could be the basis and reference factor for clinicians to make treatment decisions,and assist clinicians in making treatment decisions. |
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