Analysis Of The Effect And Influencing Factors Of ¹³¹I Treatment For Graves Hyperthyroidism

Objective（s）:The purpose of this study is to observe the efficacy of radioiodine therapy（RIT）in Graves hyperthyroidism（GH）patients,analyze and explore the relevant factors that affect the efficacy of iodine therapy,and provide theoretical basis for clinicians to formulate individualized iodine treatment plan for GH patients,To guide clinicians to publicize and educate such patients before and after iodine treatment and to develop serological indicators monitoring during the follow-up period after treatment,so as to improve the success rate or remission rate of ¹³¹I treatment and evaluate the prognosis more accurately and comprehensively.Methods:1.Data collection:A retrospective study was conducted to collect the clinical data of Graves′hyperthyroidism patients who met the inclusion criteria from the Department of Endocrinology and Nuclear Medicine of Kunming Yan’an Hospital from January 2019 to January 2022,including the patient’s sex,age,thyroid mass before ¹³¹I treatment,whether to receive anti-thyroid drug（ATD）treatment before treatment,¹³¹I dose,24 h iodine absorption function,¹³¹I conversion rate Thyroid peroxidase antibody（TPOAb）and other basic clinical and laboratory information.At 3,6 and 12 months after 131I treatment,the outpatient clinic was followed up to review the thyroid function,the patient’s symptom changes,and evaluate the treatment effect.The relationship between each factor and the efficacy was analyzed statistically（including single factor analysis and multiple factor analysis）.2.Statistical analysis:SPSS 25.0 software was used for statistical analysis in this study,and P<0.05 was the significant difference.Measurement data conforming to normal distribution shall be expressed as mean±standard deviation（±）;Measurement data that do not conform to a normal distribution（i.e.,skewed distribution）are described using a median（interquartile spacing）;The counting data is expressed by the number of cases and the constituent ratio;Chi-square test or Fisher exact probability method were used to statistically analyze the single factor data of cure rate and hypothyroidism rate of GH patients after treatment;Logistic regression analysis was used to analyze multiple factors.Results:1.Most patients with Graves’disease could achieve partial or complete remission one year after ¹³¹I treatment;The total cure rate was 80%,the incidence of hypothyroidism was 59.2%,and the non-cure rate was 20%.2.Single factor analysis found that:The cure rate of GH patients with different thyroid weight was statistically different（P<0.05）,and the incidence of hypothyroidism was not statistically different（P>0.05）.The cure rate and incidence of hypothyroidism were statistically different among GH patients with different TPOAb antibody,different ¹³¹I conversion rate and different iodine uptake rate in 24 h（P<0.05）.There were no significant differences in the cure rate and hypothyroidism rate among different genders,ATD treatment histories and TGAb antibody groups（P>0.05）.3.Multi-factor analysis found that:¹³¹I conversion rate,24 h iodine uptake rate and thyroid quality are independent factors that affect the efficacy of ¹³¹I treatment in GH patients.Conclusion（s）:¹³¹1 has a significant therapeutic effect on GH,with a total effective rate of 80%after one year of treatment;The ¹³¹I conversion rate,24-hour iodine intake rate,and thyroid quality are key factors that affect the therapeutic effect.When formulating treatment plans,key considerations should be given.