| Objective:To explore the correlation between thyroid iodine uptake rate(including 3-hour iodine uptake rate（3h RAIU）,24-hour iodine uptake rate（24h RAIU）,effective half-life and 3h/24h131I conversion rate)and efficacy of 131I in the treatment of elderly patients with hyperthyroidism,and to analyze the correlation between the clinical characteristics of elderly patients with hyperthyroidism and 24h RAIU.It provides a scientific basis for guiding the treatment of 131I.Methods:from January 2017 to August 2019,elderly patients with hyperthyroidism who were hospitalized in the department of nuclear medicine of the first affiliated hospital of Guangxi medical university for treatment of 131I,aged≥60 years,and followed up for more than six months were selected.There were a total of 63 patients,including 53 females（84.1%）and 10 males（15.9%）,aged 64（61,68）years,with a course of disease of 30（6,228）months,and a thyroid mass of 40（40,50）g.The therapeutic dose of 131I was 185.0（140.6,340.4）MBq.free triiodothyronine（FT3）was 15.01（10.81,22.09）pmol/L.free thyroxine（FT4）was 35.26（26.68,48.44）pmol/L.3h RAIU was 39.52±16.69%,and 24h RAIU was67.12±13.38%,with an effective half-life of 5.8（4.7,6.4）days.The elderly patients with hyperthyroidism were followed up for more than half a year,and the therapeutic effect was divided into the cure group（including the complete remission and hypothyroidism group）and the untreated group（including the partial remission,inefficacy and recurrence group）.According to 3h RAIU,it was divided into≤40%group（27 cases）and>40%group（36 cases）.According to the24h RAIU,the patients were divided into≤70%group（33 cases）and>70%group（30 cases）.According to the effective half-life,it can be divided into the effective half-life<5 days group（18 cases）,5 days≤the effective half-life<6 days group（16 cases）,and the effective half-life≥6 days group（29 cases）.According to 3h/24h131I conversion rate is divided into 131I conversion rate<0.6 group（39 cases）,0.6 131I or less conversion rate<0.8 group（16 cases）,131I conversion rate acuity0.8 group（8 cases）,application of chi-square test for thyroid iodine taken rate index and the correlation of 131I treatment in patients with senile hyperthyroidism curative effect is analyzed,and the patients’gender,age,course of the disease and treatment before the presence of anti-thyroid drugs（ATD）treatment history,thyroid quality,FT3,FT4,thyroid nodules and hyperthyroidism complications（granulocyte decreased,liver function damage,hyperthyroidism heart disease,exophthalmia）were correlated with 24h RAIU.Results:among the elderly patients with hyperthyroidism treated by 131I,45cases（71.4%）were cured and 18 cases（28.6%）were untreated.The difference of cure rate and unhealed rate between the group≤70%and>70%was statistically significant（x2=3.977,P<0.05）.Correlation analysis found that 24h RAIU with thyroid was positively related to relationship quality（r=0.334,P<0.05）,24h RAIU before sex,age,course of the disease,treatment with the patient whether has a history of ATD medication,quality of thyroid,FT3,FT4,thyroid nodules,hyperthyroidism complications（granulocyte decreased,liver function damage,hyperthyroidism heart disease,exophthalmia）not（P>0.05）.Conclusion:131I treatment is safe and effective for elderly patients with hyperthyroidism.In elderly patients with hyperthyroidism,24h RAIU is related to the curative effect of 131I treatment.The higher the 24h RAIU is,the higher the cure rate of 131I treatment is.24h RAIU was positively correlated with thyroid mass.The higher the thyroid mass was,the higher the 24h RAIU was.Prior to treatment with 131I,discontinuation of ATD for more than 2 weeks had no effect on 24h RAIU. |
PDF Full Text Request