儿童及青少年甲亢131I治疗的临床探讨

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1、儿童及青少年「卩亢1311治疗的临床探讨［摘耍］冃的：探讨儿童或青少年甲亢1311治疗的适应证、临床疗效及副作用等问题。方法:对58例旷20岁的儿童或青少年甲亢1311治疗示随访5年以上的病例资料进行冋顾性分析，以评价1311治疗儿童或青少年甲亢的适应证、临床疗效、副作用筹问题。结果：58例儿童或青少年甲亢患者采用1311治疗的原因分析，30例因服用内科抗甲状腺药物(Antithyroiddrug,ATD)治疗效果不佳，8例不能坚持ATD治疗，12例因ATD治疗后出现白细胞减少、皮肤过敏、肝功能受损等副作用，8例因甲状腺肿人明显(III度肿人)而直接采用1311治疗。58例患者

2、1311治疗后完全治愈45例(治愈率77.6%),好转12例(20.7%),无效］例(1.7%),总冇效率为98.3%(57/58),发生永久性甲减10例(17.2%)。所有患者治疗后均未出现明显近期副作用，随访5年以上无发生甲状腺癌、白血病及其他癌症的病例。对其中12例已生育患者调查，后代均健康，无致畸现彖发生。结论：131T治疗儿童或青少年甲亢疗效肯定、相对安全，无明显近期和远期副作用，对ATD治疗效果不佳、不能坚持ATD治疗、ATD治疗后出现明显副作用或甲状腺肿大特别明显的青少年甲亢患者，1311治疗是值得推荐的方法。［关键词］青少年甲亢；1311；治疗［中图分类号］R5

3、81［文献标识码］B［文章编号］1673-7210(2011)11(b)-171-02Clinicalstudyofchildrenoradolescenthyperthyroidismafteriodine-131therapyIJUShihongl,DUANDong21.DepartmentofNuclearMedicine,thePeople'sHospitalofTongliangCounty,Chongqing402560,China;2.DepartmentofNuclearMedicine,theFirstHospitalofChongqingMedicalUni

4、versity,Chongqing400016,China[Abstract]Objective:Toprobeintotheindication,clinicalcurativeeffectandsideeffectofchi1drenoradolescenthyperthyroidismwith131Ttherapy.Methods:58cases(agerangefrom8-20years)treatedwith1311forGraves'diseaseover5yearsfollow-upwereretrospectivestudied,andtheindication

5、,clinicalcurativeeffectandsideeffectofthetreatmentwith1311werediscusscd・Results:Thereasonstoselect131TtherapytherapeuticeffectwithtreatmentwithATD,12decreasingofleukocyteofal1patientswereanalyzed,30ofthemhadnogoodantithyroiddrugs(ATD),8ofthemcould'tadheretotheofthempresentedsideeffect(includ

6、ingskinallergy,andimpairingofliverfunction)afterATDtreatment,and8caseshadobviouslygoitrous(degreeIII)andusedthetreatmentof1311.Over5yearsfollow-up,45cases(77.6%)wereoncecuredamongthe58patients,improvementin12cases(20.7%),hypothyroidismin10cases(17.2%),andineffectivein1caseTherewerenoearlysid

7、eeffectandthyroidcancer,leukemiaorothermalignanciesinallcasesaftertreatment,neitherwereteratogenesisinprogenyof12legitimate.Conelusion:1311isfoundtobeaneffectiveandsafetreatmentofGraves，diseaseinchildrenoradolescents,forpatientswhohavenoidealtherap