| Objectives:In this study,dynamic imaging of salivary glands was used to quantitatively evaluate the effect of related factors,mainly intervention of vitamin E pretreatment,on the salivary gland function of differentiated thyroid cancer patients during the first 131I therapy.Methods:This study collected and analyzed the differentiated thyroid cancer patients who were going to receive the first 131I therapy from November 2018 to July 2019 in the Department of Nuclear Medicine of the First Affiliated Hospital of China Medical University.The enrolled patients were randomly divided into the test group and the control group according to the admission time.All patients in the test group received vitamin E for a duration of l week before to 1 month after the administration of 131I,and other preparations were the same as those in the control group.Each group started receiving vitamin C 2 hours after 131I treatment,taking 100 mg every 4 hours for 5consecutive days,except for sleep time.99mTcO4-thyroid static imaging was performed before 131I treatment.The results were analyzed by visual analysis method.According to the imaging results,the enrolled patients were divided into the residual thyroid group?positive imaging?and the non-residual thyroid group?negative imaging?.According to the different 131I dosage,patients were divided into small dose group?1.85GBq?,medium dose group?2.8GBq?and large dose group?3.7GBq?.All patients completed dynamic imaging of salivary glands before 131I treatment and 4 months after 131I treatment.Computer technology was used to quantitatively analyze the difference within the 15 min uptake rates and the excretion fractions of each gland before and after 131I therapy.The possible factors that may affect the salivary gland function(including the age,gender,residual thyroid,131I dosage,intervention of vitamin E pretreament)were analyzed using multivariate analysis method.Binary Logistic regression analysis was employed for multivariate analysis.P<0.05 was considered statistically significant.Results:The final eligible patients were 116,including 28 male patients?24.1%?and 88female patients?75.9%?with an average age of 43.6±11.3 years.There were 63 cases in the test group and 53 cases in the control group.Before 131I therapy,60 cases?51.7%?had residual thyroid tissue,and 56 cases?48.3%?had no residual thyroid tissue.Among all patients,50 cases?43.1%?were treated with 131I at small doses,21 cases?18.1%?at medium doses,and 45 cases?38.3%?at high doses.For all patients,the 15 minute uptake rate and the excretion fraction of 232 parotid glands and submandibular glands were collected,and the corresponding differences before and after 131I treatment were analyzed.There were107 parotid glands'and 109 submandibular glands'15 min uptake rates were lower after the treatment.And there were 102 parotid glands'and 98 submandibular glands'percentage of excretion fractions were lower after the treatment.Multivariate analysis revealed that the effects of age,gender,residual thyroid tissue,and intervention of vitamin E pretreatment on salivary gland function were not statistically significant?all P>0.05?.131I treatment dose?OR=1.560,95%CI:1.145-2.124,P=0.005?was an independent influencing factor for uptake dysfunction of submandibular gland,while it can not affect the parotid gland function and the excretion function of submandibular gland?P>0.05?.Conclusions:Intervention of vitamin E pretreament,compared with vitamin C alone,has no obvious effect on the salivary gland function in differentiated thyroid cancer patients received the first 131I therapy.Age,gender and residual thyroid tissue have no obvious effect on the salivary gland function of differentiated thyroid cancer patients during the first 131I therapy.131I treatment dose is an independent influencing factor for uptake dysfunction of submandibular gland.The larger the dose,the more likely submandibular gland uptake dysfunction will occur. |
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