Japanese
Title甲状腺機能亢進症131I治療後の機能低下症に関する検討
Subtitle原著
Authors久保敦司*, 近藤誠*, 木下文雄**, 前川全**, 岡本二郎***, 七理泰***, 馬場理一***
Authors(kana)
Organization*慶応義塾大学医学部放射線科, **都立大久保病院放射線科, ***内科
Journal核医学
Volume14
Number1
Page59-71
Year/Month1977/2
Article原著
Publisher日本核医学会
Abstract「I. はじめに」甲状腺機能亢進症の三大治療法の一つである131I治療は, 患者に対する侵襲のない簡便かつ確実な治療法として広く行われている. 本療法が行なわれる様になった当初, 最も憂慮されていた副作用は発癌および遺伝的影響であったが, 30余年経過した現在, 131I治療後に甲状腺癌や白血病が発生したといういくつかの症例報告はあるものの, いずれもそれらの自然発生率との有意の差は認めていない. 発癌性および遺伝的影響についてはさらに今後十分な経過観察の後, 結論を出さねばならないが, それとは別に晩発性副作用の一つである甲状腺機能低下症の発生が意外に多いことが近年大きな問題となってきた. 著者らは過去20年間における131I治療の遠隔成績についてはすでに報告してきたが, 今回は特に131I治療後高率に発生する晩発生機能低下症を中心に再検討したので報告する. 「II. 対象」対象としては昭和30年より昭和49年までの20年間に都立大久保病院および慶応義塾大学病院放射線科にて131I治療を施行した甲状腺機能亢進症890例である.
Practice臨床医学：一般
Keywords
English
TitleHypothyroidism Following 131I Therapy for Hyperthyroidism
SubtitleOriginal Articles
AuthorsAtsushi KUBO, Makoto KONDO1), Fumio KINOSHITA, Akira MAEKAWA, Jiro OKAMOTO, Yasushi SHICHIRI, Riichi BABA2)
Authors(kana)
Organization1)Department of Radiology, Keio University School of Medicine, 2)Department of Radiology and Department of Internal Medicine, Ohkubo Municipal Hospital
JournalThe Japanese Journal of nuclear medicine
Volume14
Number1
Page59-71
Year/Month1977/2
ArticleOriginal article
PublisherTHE JAPANESE SOCIETY OF NUCLEAR MEDICINE
AbstractClinical results of 890 patients with hyperthyroidism, to which 131I therapy had been conducted, are reported with reference to hypothyroidism after 131I therapy as follows: 1)Results of 131I therapy were examined in patients who could be followed up. These comprised 584 of 890 patients; of these 502(86%), including 3 patients who had completely healed after recurrence, were cured, 9patients are still under medical treatment, and 10 died. 2)The incidence of hypothyroidism following 131Itherapy was 1.6%after 1 year, 2.3%after 2years, 4.7%after 5 years, 15.0%after 10-12years, 22.1% after 13-15 years and 27.5% after 16-20years. The incidence increased constantly with passage of time. 3)Factors influencing the response to treatment have been investigated. As a consequence, the amount of rads delivered to the thyroid gland, the gland size and previous surgery correlated with the incidence of hypothyroidism. The number of doses of 131I, uptake and half-life of 131I in the thyroid, previous antithyroid medication, time between the onset of hyperthyroid symptoms and 131Itherapy, age or sex of the patients appeared unrelated. 4)The times taken to become euthyroid following a single dose of 131I were 5.6 months in 2000-4000rads, 4.4 months in 4001-7000 rads, 4.2 months in 7001-10000 rads and 3.5 months in more than 10001 rads. The time was prolonged with decrease of rads delivered to the thyroid gland. 5)It was found that the patients who passed through a transient hypothyroid phase in the period of three to four months after administration of 131I had a high incidence of late permanent hypothyroidism.
PracticeClinical medicine
Keywords

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