Correlation analysis between outcome of exophthalmos and curative effect of hyperthyroidism in Graves disease after 131I therapy

Abstract

Objective To analyze the association between the outcome of exophthalmos and the curative effect of hyperthyroidism in Graves disease after 131I therapy.Methods Five hundred and thirty-eight cases of Graves disease accompanied with exophthalmos and hyperthyroidism who received 131I therapy from January 2001 to January 2010 were reviewed retrospectively,and the association between the outcome of exophthalmos and the curative effect of hyperthyroidism was analyzed.Results The effective rate of hyperthyroidism after 131I therapy was 94.8％ (510/538).The effective rate of exophthalmos after 131I therapy was 73.2％(394/538).And the effective rate of hyperthyroidism with exophthalmos was 71.6％ (385/538).The incidence of improvement,inefficiency,exacerbation was 75.5％ (385/510),21.0％ (107/510),3.5％( 18/510) in hyperthyroidism effective patients ( 510 cases ) and 32.1％ ( 9/28 ),50.0％ ( 14/28 ),17.9％ ( 5/28 )in hyperthyroidism ineffective and recrudescence patients (28 cases),there was significant difference between the two patients (P ＜ 0.05 ).The incidences of improvement,inefficiency,exacerbation were 78.1％(281/360),18.9％(68/360),3.1％(11/360) in hyperthyroidism cured patients(360 cases),78.2％(36/46),17.4％ (8/46),4.3％ (2/46) in hypothyroidism patients (46 cases),there was no significant difference between the two (P ＞ 0.05 ).The incidence of improvement,inefficiency,exacerbation was 86.4％ ( 229/265 ),9.8％(26/265 ),3.8％( 10/265 ) in mild exophthalmos after 131I therapy(265 cases),59.9％(106/177),35.6％(63/177),4.5％(8/177) in moderate and severe inactive exophthalmos after 131I therapy( 177 cases),there were significant differences in the inciclence of improvement and inefficiency between the two patients (P＜0.05).For patients with moderate and severe active exophthalmos,glucocorticoids therapy could obtain satisfactory effect.Conclusion 131I therapy is an effective method for Graves disease with exophthalmos,and there is a significant association between the outcome of exophthalmos and the curative effect of hyperthyroidism. Key words: Graves ophthalmopathy; Exophthalmos; Iodine isotopes