不同剂量131I对分化型甲状腺癌患者摄碘率、甲状腺激素水平及生活质量的影响

摘要 目的：探讨不同剂量¹³¹I对分化型甲状腺癌（DTC）患者摄碘率、甲状腺激素水平及生活质量的影响。方法：选取2018年6月～2020年6月我院收治的DTC患者100例，均接受¹³¹I清甲治疗，根据放射剂量的不同分为小剂量组（100mci）和大剂量组（150mci），例数均为50例。比较两组患者摄碘率、甲状腺激素水平、肝肾功能、生活质量和不良反应发生率。结果：小剂量组2 h、6 h、24 h的摄碘率高于大剂量组（P<0.05）。小剂量组的清甲率高于大剂量组（P<0.05）。两组治疗1个月后促甲状腺激素（TSH）、游离三碘甲状腺原氨酸（FT3）、甲状腺球蛋白（TG）水平下降（P<0.05）；小剂量组治疗1个月后TSH、FT3、TG水平低于大剂量组（P<0.05）。两组治疗前、治疗1个月后的组间、组内门冬氨酸氨基转移酶（AST）、丙氨酸氨基转移酶（ALT）、碱性磷酸酶（ALP）、血清尿素（Urea）、肌酐（Cr）、尿酸（UA）水平对比，差异均无统计学意义（P>0.05）。小剂量组的生活质量优良率高于大剂量组（P<0.05）。小剂量组的不良反应发生率低于大剂量组（P<0.05）。结论：不同剂量¹³¹I清甲治疗对DTC患者肝肾功能无明显影响，但选用100mci剂量可提高DTC患者摄碘率，减轻对甲状腺功能的损害，同时还可提高患者的生活质量，减少不良反应发生率。

Effects of Different Doses of 131I on Iodine Uptake Rate, Thyroid Hormone Level and Quality of Life in Patients with Differentiated Thyroid Cancer

ABSTRACT Objective: To investigate the effects of different doses of ¹³¹I on iodine intake rate, thyroid hormone level and quality of life in patients with differentiated thyroid carcinoma (DTC). Methods: 100 patients with DTC who were admitted to our hospital from June 2018 to June 2020 were selected. All of them received ¹³¹I nail removal treatment. They were divided into low-dose group (100mci) and high-dose group (150mci) according to different radiation doses, the number of patients was 50 cases. The iodine intake rate, thyroid hormone level, liver and kidney function, quality of life and incidence of adverse reactions were compared between the two groups. Results: The iodine uptake rate at 2 h, 6 h and 24 h in the low-dose group was higher than that in the high-dose group (P<0.05). The nail clearance rate on the low-dose group was higher than that in the high-dose group(P<0.05). 1 month after treatment, the thyroid stimulating hormone (TSH), free triiodothyronine (FT3) and thyroglobulin (TG) levels in the two groups decreased (P<0.05). The TSH, FT3 and TG levels in the low-dose group were lower than those in the high-dose group at 1 month after treatment(P<0.05). The aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), serum urea (Urea), creatinine (Cr) and uric acid (UA) levels in the two groups before treatment and 1 month after treatment were not significantly different(P>0.05). The excellent and good rate of quality of life in the low-dose group was higher than that in the high-dose group(P<0.05). The incidence of adverse reactions in the low-dose group was lower than that in the high-dose group(P<0.05). Conclusion: Different doses of ¹³¹I have no significant effect on the liver and kidney function of patients with DTC, but the dose of 100mci can improve the iodine intake rate of patients with DTC, reduce the damage to thyroid function, improve the quality of life of patients, and reduce the incidence of adverse reactions.