Effect tracking of 131I treatment in Graves' hyperthyroidism patients within 1 year and analysis of the factors that may influence the cure.

Abstract

To observe the disease development and outcome of Graves' disease (GD) patients within 1 year after iodine-131 (131I) treatment, and analyze the factors affecting the treatment effect. Clinical data of 221 patients who received the first treatment with 131I in our department from June 2016 to October 2018 were retrospectively analyzed and they were followed up at 3 months, 6 months and 1 year after the treatment. According to the three follow-up records, the cure rate was calculated and the follow-up chart was drawn. The factors that may affect the clinical cure were analyzed according to the follow-up results after 1 year: Independent risk factors affecting the prognosis were screened out by Logistic regression analysis, and the effects of the above factors on the prognosis were further analyzed by Chi-square test, and the cure multiple relationship caused by the influencing factors was analyzed by Logistic regression analysis. The cure rate was 58.82% and the effective rate was 71.95%. At the 3-month follow-up, 11 patients (4.98%) presented complete response, 99 patients (44.80%) presented hypothyroidism, 93 patients (42.08%) presented partial response, and 18 patients (8.14%) presented no effect or recurrence. At 6 months, 18 cases (8.14%) had complete response, 90 cases (40.72%) had hypothyroidism, 59 cases (26.70%) had partial response, and 54 cases (24.43%) had no effect or recurrence. At 12 months, 36 cases (16.29%) had complete response, 94 cases (42.53%) had hypothyroidism, 29 cases (13.12%) had partial response, and 62 cases (28.05%) had no effect or recurrence. Thyroid weight and thyroid peroxidase antibody (TPOAb) were the influencing factors. Among all patients, patients with thyroid weight ≤28.70g were 4.25 times more likely to achieve clinical cure than patients with >28.70g [OR (95%CI):4.252 (2.383-7.588), P<0.01)], female patients with the thyroid weight ≤28.70g was 5.78 times than those with >28.70g [OR (95%CI): 5.776 (2.951-11.308), P<0.01]. In male, patients with TPOAb≤449.00IU/mL were 0.27 times more likely to achieve clinical cure than those with >449.00IU/mL [OR (95%CI): 0.274 (0.081-0.919), P<0.05]. Iodine-131 was an effective treatment to GD. Thyroid weight before treatment was the influencing factor for all patients and female patients, while TPOAb was the influencing factor for male patients.