Objective To investigate the predictive value of early thyroid function changes on the efficacy of patients with Graves'disease(GD)after 131I therapy.Methods Data of patients with GD(59 males,214 females;age(37.4±11.4)years)who underwent single therapy of 131I in Tianjin Medical Uni-versity General Hospital from November 2017 to January 2019 were retrospectively analyzed.Symptoms,signs and laboratory tests(serum free triiodothyronine(FT3)and serum free thyroxine(FT4))of patients were observed to assess the efficacy of 131I treatment.Efficacy was divided into complete remission(CR),partial remission(PR),non-remission(NR)or relapse.The changes of thyroid function(△FT3=FT3 be-fore treatment-FT3 after treatment)/FT3 before treatment × 100％;△FT4=FT4 before treatment-FT4 after treatment)/FT4 before treatmentx100％)1 month after 131I therapy in each eficacy group and differences among them were compared by using independent-sample t test,x2 test,one-way analysis of variance and the least significant difference t test.ROC curves were drawn to analyze the predictive values of early thyroid function changes on the efficacy of 131I treatment for GD.Logistic regression analyses were performed to identify the influencing factors for the effiicacy of 131I therapy.Results CR rate and total effective rate of 273 GD pa-tients after single therapy of 131I were 67.03％(183/273)and 92.67％(253/273),respectively.After 1 month,CR rate of euthyroidism group(n-95)was significantly higher than that of hyperthyroidism group(n=178;81.05％(77/95)vs 59.55％(106/178);x2=4.60,P=0.032).△FT3 and △FT4 at the first month were statistically significant and decreased sequentially in the CR group(n=183),PR group(n=70),NR or relapse groups(n=20;F values:15.40,12.54,both P＜0.001).ROC curve analysis showed that patients with △FT3 ≥73.64％and(or)△FT4 ≥59.03％had a higher probability of achieving CR,with sensitivities of 84.3％and 86.7％,and specificities of 62.6％and 62.6％,respectively.Logistic regression analysis showed that 24 h radioactive iodine uptake(odds ratio(OR)=1.095,95％CI:1.031-1.139),dose of 131I given per gram of thyroid tissue(OR=1.562,95％CI:1.321-1.694),△FT3(OR=1.354,95％CI:1.295-1.482),△FT4(OR=1.498,95％CI:1.384-1.608)were factors affecting the outcome of patients with GD treated with 131I treatment(all P＜0.05).Conclusion Effects of 131I treatment can be pre-dicted based on the change of the thyroid function at the first month after 31I treatment in patients with GD.
Graves diseaseRadiotherapyIodine radioisotopesThyroid function testsTreat-ment outcome
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