| 邹文,廖梓宏,耿峻.格雷夫斯病病人 131I治疗后甲状腺功能减退的预测因素[J].安徽医药,2025,29(7):1437-1441. |
| 格雷夫斯病病人 131I治疗后甲状腺功能减退的预测因素 |
| Predictive factors of hypothyroidism in Graves disease patients after 131I treatment |
| |
| DOI：10.3969/j.issn.1009-6469.2025.07.035 |
| 中文关键词: 格雷夫斯病 放射性碘 甲状腺功能减退 回顾性分析 危险因素 |
| 英文关键词: Graves disease Radioiodine Hypothyroidism Retrospective analysis Risk factor |
| 基金项目: |
|
| 摘要点击次数: 783 |
| 全文下载次数: 200 |
| 中文摘要: |
| 目的分析格雷夫斯病( Graves disease，GD)病人放射性碘同位素 131(131I)治疗后甲状腺功能减退(甲减)的预测因素。方法收集 2012—2021年内江市第一人民医院、内江市第二人民医院和威远中医院共 364例行 131I治疗的 GD病人为研究对象，随访时间均 ≥3年，分析甲减发生率。通过病案系统收集病人一般信息、 GD疾病特征、合并症、治疗情况。采用 t检验比较符合正态分布的定量资料； Mann-Whitney U检验比较不符合正态分布的定量资料； χ2检验比较分类资料。采用 logistic回归进行多因素分析。采用受试者操作特征曲线( ROC曲线)分析筛选所得指标预测甲减的效能。结果 194例病人出现甲减，甲减发生率 53.3%。单因素分析结果显示，甲减组基线抗甲状腺过氧化物酶抗体( thyroid peroxidase antibodies，TPOAb)阳性率较高，甲状腺质量较小， 24 h摄碘率较低，服碘量［( 7.4±2.7)mCi，(6.2±2.4)mCi］较高( P<0.05)。多因素分析结果显示:甲状腺质量、基线 TPOAb、服碘量是 GD病人 131I治疗后甲减的独立影响因素( P<0.05)。甲状腺质量、基线 TOPAb表达、服碘量联合预测甲减的曲线下面积( AUC)及其 95%CI为 0.80(0.80，0.87)(P<0.001)。结论甲状腺质量、基线 TOPAb表达、服碘量可作为 GD病人 131I治疗后甲减预测指标，且上述指标联合预测的准确性高于单独指标预测。 |
| 英文摘要: |
| Objective To analyze the predictive factors of hypothyroidism after 131I treatment in patients with Graves disease (GD). Methods A total of 364 GD patients treated with 131I in the First People's Hospital of Neijiang City, the Second People's Hospital ofNeijiang City and Weiyuan Hospital of Traditional Chinese Medicine from 2012 to 2021 were collected as the research objects, and the follow-up time was ≥ 3 years. The incidence of hypothyroidism was analyzed. Following data were collected through the medical recordsystem: general information of patients, characteristics of GD diseases, complications and treatment conditions. The quantitative data inaccordance with normal distribution were compared by t test; Mann Whitney U test was used to compare quantitative data that did notconform to normal distribution; classification data using chi square test were compared. Multiple factor analysis was conducted using lo-gistic regression. Receiver operating characteristic curve (ROC curve) analysis was used to screen indicators to predict the effectivenessof hypothyroidism.Results A total of 194 cases had hypothyroidism, and the incidence of hypothyroidism was 53.3%. Univariate anal-ysis showed that the baseline TPOAb positive rate of hypothyroidism group patients was higher, the thyroid weight was smaller, the 24 hiodine intake rate was lower, and the iodine intake [(7.4±2.7) mCi, (6.2±2.4) mCi] was higher (P<0.05). Multivariate analysis showedthat thyroid weight, baseline TPOAb and iodine intake were independent influencing factors of hypothyroidism in GD patients after 131I treatment (P<0.05). The area under the curve (AUC) 95%CI predicted by the combination of thyroid weight, baseline TOPAb expres-sion and iodine intake was 0.80 (0.80, 0.87) (P<0.001).Conclusion Thyroid weight, baseline TOPAb expression and iodine intake can be used as predictors of hypothyroidism in patients with GD after 131I treatment, and the accuracy of combined prediction of these indexes is higher than that of single index. |
|
查看全文
查看/发表评论 下载PDF阅读器 |
| 关闭 |
|
|
|
