| 高刘艳,何伟,李云波,唐海利,袁梦晖,王俊燕,白芡蓉,魏光明.分化型甲状腺癌患者131I治疗后体内放射性总活度的变化及影响因素[J].中华放射医学与防护杂志,2022,42(12):973-979 |
| 分化型甲状腺癌患者131I治疗后体内放射性总活度的变化及影响因素 |
| Factors influencing changes in total radioactivity in differentiated thyroid cancer patients after 131I treatment |
| 投稿时间：2022-09-06 |
| DOI：10.3760/cma.j.cn112271-20220906-00361 |
| 中文关键词: 分化型甲状腺癌|131I治疗|体内放射性总活度|全身辐射监测系统 |
| 英文关键词:Differentiated thyroid cancer|Radioactive iodine therapy|Whole body radiation monitoring system|Total radiation activity in vivo |
| 基金项目:陕西省自然科学基础研究计划一般项目(2022JM-604) |
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| 中文摘要: |
| 目的 探讨131I治疗分化型甲状腺癌(differentiated thyroid carcinoma,DTC)术后患者体内放射性总活度的变化及其代谢的影响因素。方法 回顾性分析2021年9月至2022年4月于空军军医大学第二附属医院核医学科接受131I治疗的218例DTC术后患者的临床资料,根据服用131I的剂量分为低剂量组(≤3.7 GBq)171例和高剂量组(＞3.7 GBq)47例,使用全身动态辐射监测系统在服用131I后24、48及72 h测定体内131I残留活度并探讨其变化的影响因素。结果 服用131I后低剂量组24、48及72 h的体内131I残留活度均明显低于高剂量组(t=-7.46、-3.31、-2.01,P<0.05);低剂量组24、48 h出院达标率明显高于高剂量组(21.0%vs. 4.3%、98.2%vs. 89.4%,χ2=7.23、5.91,P<0.05),且所有患者在72 h均可达出院标准。单因素分析显示患者24及48 h体内131I残留活度与年龄、体质量指数(body mass index,BMI)、基础代谢率(basal metabolism rate,BMR)及促甲状腺激素(thyroid stimulating hormone,TSH)有关。多元线性回归分析显示低剂量组24 h时年龄越大、BMR越高、TSH水平越高,体内131I残留活度越大,48 h时BMI越大、TSH越高,体内131I残留活度越大;高剂量组24 h时年龄越大、BMR越高,体内131I残留活度越大。患者体内131I残留活度达到400 MBq的时间以24、36 h来分析其影响因素,结果显示以24 h为分界时,TSH水平越低,体内131I残留活度越低;以36 h为分界时,年龄越小、TSH水平越低、131I治疗剂量越小,体内131I残留活度越低。结论 年龄、BMI、BMR及TSH水平是131I治疗DTC术后患者体内放射性总活度的影响因素,联合上述指标进行辐射剂量评估可为调整患者住院时长提供参考。 |
| 英文摘要: |
| Objective To investigate the changes in total radioactivity in patient body with differentiated thyroid carcinoma (DTC) after 131I treatment and the factors influencing its metabolism.Methods The clinical data from 218 patients after DTC treatment in the Department of Nuclear Medicine, the Second Affiliated Hospital of Air Force Medical University from September 2021 to April 2022 were retrospectively analyzed. Based on administrated 131I dose, 171 patients were divided into low-dose group (≤ 3.7 GBq) and 47 into high-dose group (＞3.7 GBq). A whole body dynamic radiation monitoring system was used to measure the in vivo residual activity of 131I 24, 48 and 72 h after 131I administration and to explore their influencing factors.Results 24, 48 and 72 h after adimination of 131I, the residual activity of 131I in the low-dose group patients was significantly lower than in the high-dose group patients (t= -7.46, -3.31, -2.01, P<0.05). The discharge compliance rate at 24 and 48 h in the low-dose group was significantly higher than that in the high-dose group (21.0% vs. 4.3%, 98.2% vs. 89.4%, χ2 = 7.23, 5.91, P<0.05), and all patients could meet the discharge criteria at 72 h. Univariate analysis showed that the residual131I activity at 24 and 48 h was dependent on age, body mass index (BMI), basal metabolism rate (BMR) and thyroid stimulating hormone (TSH). As have been shown by multiple linear regression analysis, in the low-dose group, the older age, the higher BMR and the higher TSH level at 24 h tended to the higher 131I residual activity in the body. At 48 h, the higher BMI and the higher TSH level lead to the higher 131I residual activity in patient body. Meanwhile,in the high-dose group, the higher age and BMR at 24 h,tended to the higher in vivo 131I residual activity. The influencing factors were analyzed in terms that 131I residual activity reaching 400 MBq in patient body at 24 and 36 h. The result showed that at 24 h the lower TSH level leaded to the lower 131I residual activity in patient body. At 36 h, the younger age, the lower TSH level, and the smaller 131I treatment dose tended to the lower in vivo 131I residual activity.Conclusions Age, BMI, BMR and TSH levels are the influencing factors for the change in total activity in patient body after 131I treatment of DTC. Radiation dose assessment based on the above indicators can provide a reference for adjusting the length of hospitalization time. |
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