甲状腺機能充進症にたいする131I治療後の甲状腺機能検査の臨床的意義

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Determinations of 24-hour thyroidal uptake of131I (Uptake), basal metabolic rate (BMR) and serum protein bound iodine (PBI), and clinical evaluations of thyroid status were made on 84 patients who had received 131 I therapy for hyperthyroidism. These patients were followed up from one to five years after the final therapy. The clinicl significance of the tests after the 131I therapy, and prognostic value of each test and clinical status were analyzed. 1) Disagreement between uptake and clinical status increased after the therapy, and in the clinically hyperthyroid state, it reached up to 50%. Moreover normal or low uptake values 3 to 6 months after the 131I therapy were hardly in agreement with the clinical status. 2) In patients with clinical hyperthyroidism after the therapy and in patients with normal BMR values after the treatment, BMR and clinical status showed almost 100% agreement. 3) Generally, PBI levels showed decreased agreement with the clinical status after the therapy. This tendency was especially marked in patiens who became clinically euthyroid after the therapy. PBI levels were generally rather low in these patients. On the contrary, high PBI levels indicated an almost clinically hyperthyroid state. 4) These disagreements between laboratory data and clinical status decreased by the combined interpretation of three thyroid function tests. 5) Statistically, the difference in the mean values of laboratory data between failure and success groups became evident, in Uptake test 7 months, in BMR and PBI 3 months after the 131I therapy, and this marked difference seemed to be valuable prognostically. 6) Patients in the failure group generally showed a clinical hyperthyroid state throughout the course after the treatment. Almost all of the patients in the success group were clinically euthyroid 13 months or later after the treatment, some of them were clinically hyperthyroid even within 12 months after the treatment. From these data, it is concluded that there are rather large discrepancies between results of thyroid function tests and clinical status after the131I therapy. Among them BMR exprsses the clinical status relatively better, but the significance of the clinical status for the determination of the prognosis of each patient cannot be underestimated.
日本内分泌学会の論文

甲状腺機能充進症にたいする<SUP>131</SUP>I治療後の甲状腺機能検査の臨床的意義

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