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그레이브스병 환자에서 방사성 옥소(^131Ⅰ)치료의 효과
노흥규,안봉수,신재규,주언찬,송민호 충남대학교 의과대학 지역사회의학연구소 1996 충남의대잡지 Vol.23 No.2
Graves' disease is characterized by diffuse hyperplasia of thyroid gland, hypersecretion of thyroid hormones, ophthalmopathy, and localized pretibial myxema. Although the pathogenesis of Graves' disease is still obscure, but the TSH receptor antibodies have pathophysiological role in the hyperplasia of the gland and autonomous over production of thyroid hormones through the stimulation of TSH receptor. Radioiodine (^1311I) has been used for the treatment of Graves' disease for many years and is regarded as an treatment for the cases who is not remit following a course of antithyroid drug. To evaluate the efficacy and side effects of radioiodine treatment in Graves' disease, we studied clincal outcome after fixed dose(5-20mCi) of ^131I The results were as followings; 1) The mean dose of 9. 1mCi of ^131I administration makes 12 patients euthyroid out of 41 patients with Graves' disease. The dose of radioiodine(^131I) used for the treatment was not significantly different in hypothyroid group (3/41; 7.3%) or hyperthyroid group(26/41; 63.4%) after ^131I treatment. 2) The clinical outcomes after radioiodine (131I) treatment was not depend on the age and sex and thyrotropin receptor binding inhibitory immunoglobulins(TBII) of radioiodine(^131I) administered patients, but only the short duration of antithyroid drug treatment(the period of observation of the responce to antithyroid drug) before the radioiodine administration increase the incidence of radioiodine induced hypothyroidism. 3) The cumulative incidence of hypothyoidism after radioiodine(^131I) administration was 39.4% after third treatment. In conlusion, radioiodine treatment in fixed-dose is effective; it can induce euthyroidism or hypothyroidism in 33 out of 41 patients without major complications. With this study, we could confirm the efficacy of radioiodine treatment in a minor groups of patient who its difficult to maintain remission after antithyroid drug.
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