Thyroid Two Unequal Leaf Size Of ¹³¹I Therapy On The Efficacy Of Graves’ Disease

Objective:Graves’ disease is the most common clinical endocrine disease, radioactive ¹³¹ I therapy is the main treatment for Graves’ disease, the treatment effect influenced by many factors. This paper discusses the ¹³¹ I treatment of Graves’ disease, the thyroid gland two leaves of different sizes affect their therapeutic effect.Methods:Choose between January 2014 to December 2014, at the First Hospital of Shanxi Medical University, Department of Nuclear Medicine naive ¹³¹ I treatment of 384 cases of Graves’ disease. Exclude thyroid scintigraphy nodules（hot,warm,cool,cold nodule）and B-confirmed colloid nodules, adenoma, calcification, hyperplasia. All patients received¹³¹ I therapy before underwent thyroid scintigraphy estimates outlined two thyroid lobe ROI, two leaves were recorded radioactivity counting and calculating the ratio of the difference between the two leaf count.According thyroid radionuclide imaging radioactive counts two leaf ratio difference absolute value, the clinical data were divided into four groups: Group A was ratio difference range 20% or higher, A total of 23 cases; Group B was difference range acuity10% and < 20%, a total of 54 cases; Group C was difference range acuity 5% and < 10%,a total of 153 patients; Group D for difference range of < 5%, a total of 154 cases. After¹³¹ I treatment 12 months follow-up results and to determine their efficacy criteria refer to "¹³¹I therapy for Graves disease Directory（2013 Edition）", and complete remission aftertreatment as a cure for hypothyroidism group, partial remission or relapsed as not more groups.Using SPSS20.0 software for data processing, quantitative data using said,qualitative data adoption or forming than said. The comparison between the two sets of quantitative data using t test, the ratio between the different groups or forms than comparison using χ2 test, the thyroid lobes ratio between various methods in using Pearson correlation analysis. With P < 0.05 for the difference was statistically significant.Results:1、A, B, C, D four groups of patients with the cure rate was 78.26%（18/23）, 81.48%（44/54）, 91.50%（140/153）, 93.51%（144/154）. Between group A and group D（chi-square = 6.00, P < 6.00）, group B and group D（chi-square = 6.65, P < 0.05）,compared statistically significant between group C and group D（chi-square = 1.65, P >1.65） is no statistical difference; Between group A and group C（chi-square = 3.82, P <3.82）, group B and group C（chi-square = 4.06, P < 0.05） is statistically significant, no statistical difference between group A and group B（chi-square = 0.11, P > 0.11）. Four groups of patients with minor improvement rate was 21.74%（5/23）, 18.52%（10/54）,8.50%（13/153）, 6.49%（10/154）. Between group A and group D, group B and group D minor improvement rate was statistically difference is compared between, between group C and group D minor improvement rate is no statistical difference between; Group A and group C, group B and group C minor improvement rate is statistically significant between, between group A and group B is no statistical difference between minor improvement rate.2、384 patients with Graves disease of thyroid lobes radioactive count contrast value was 0.12 +/- 0.25 on average, lobes long axis contrast value was 0.11 +/- 0.07 on average,lobes short axis contrast value was 0.13 +/- 0.12 on average, two leaf area contrast value was 0.18 +/- 0.13 on average. Thyroid lobes long axis contrast value contrast with radioactive count value correlation coefficient is 0.148, short axis contrast with radioactive count contrast value correlation coefficient is 0.008, the area of contrast withradioactive count correlation coefficient is 0.021, no correlation.3、Cure patients of group A and group not cured patients with ¹³¹ I treatment plan quantity were 4.56 +/- 1.89 MBq and 5.01 +/- 2.21 MBq, B group cure group with minor improvement plan quantity were 4.21+/- 1.35 MBq and 4.83+/- 1.93 MBq, cure group C with minor improvement group plan quantity were 4.01+/- 0.93 MBq and 3.97+/- 1.62 MBq, D group cure group with minor improvement plan quantity were 3.84+/- 0.84 MBq and 3.78+/- 1.48 MBq. A、B、C、D respectively in four groups within the group to compare the plan of ¹³¹ I no statistical difference（P > 0.05）,Most patients in group A, B,C group of ¹³¹ I treatment plan and cure group in group D ¹³¹ I treatment plan A quantity,A, B group of ¹³¹ I treatment plan and cure group in group D ¹³¹ I treatment plan quantity is statistically significant（P < 0.05）, the amount of ¹³¹ I treatment plan of group C and group D cure group in ¹³¹ I treatment plan quantity is no statistical difference（P > 0.05）.Conclusion:¹³¹I treatment for Graves disease, patients with thyroid lobes unequal size influence the treatment effect, thyroid lobe radioactive count contrast value 10% or higher, its cure rate obviously to reduce, not cured rate significantly increased. Suggestions in clinical treatment of two leaves is not equal to the size of the Graves disease, consider the appropriate increase the amount of ¹³¹ I treatment plan.