Japanese
Title甲状腺機能亢進症の放射性ヨード治療後の晩発性甲状腺機能低下症および生命的予後
Subtitle原著
Authors藤井秀樹*
Authors(kana)
Organization*鳥取大学医学部放射線医学教室
Journal核医学
Volume28
Number9
Page1067-1073
Year/Month1991/9
Article原著
Publisher日本核医学会
Abstract「要旨」本邦で1953〜1967年に甲状腺機能亢進症の放射性ヨード治療が行われた7,325例を対象として追跡調査を行った. このうち甲状腺ホルモン補充療法の有無の明らかとなった1,892例について, 補充療法の有無により判定して, 甲状腺機能低下症の頻度, 発生時期, その背景を検討した. 女性, 30歳代, 放射性ヨードの多い症例で低下症が多かった. また, 従来の報告と同様, 経年的な低下症の増加も認められ, 継続した経過観察が重要である. 甲状腺腫瘍の発生についても検討したが, 放射性ヨード治療例で明らかな腫瘍発生の増加は認めなかった. 生命的予後としては, 一般大衆の死亡率を用いて対象の期待死亡数を求め評価した. 有効回答のあった2,379例を対象としたが, 放射性ヨード治療群で死亡および癌死亡の有意な増加は認めなかった. 若年治療群でも死亡の増加はなかったが, 放射性ヨード大量投与群で全死亡の増加傾向があり, 低下症の関与が懸念され, この点からも厳重な経過観察が重要で適切な補充療法の開始が望まれる.
Practice臨床医学:一般
KeywordsHyperthyroidism, Radioiodine therapy, Late-onset hypothyroidism, Thyroid tumor, mortality.
English
TitleA Long-term Follow-up Study of Late-onset Hypothyroidism and Prognosis of Hyperthyroid Patients Treated with Radioiodine
SubtitleOriginal Articles
AuthorsHideki FUJII
Authors(kana)
OrganizationDepartment of Radiology, Tottori University School of Medicine
JournalThe Japanese Journal of nuclear medicine
Volume28
Number9
Page1067-1073
Year/Month1991/9
ArticleOriginal article
PublisherTHE JAPANESE SOCIETY OF NUCLEAR MEDICINE
Abstract[Summary]We performed a follow-up study of 7,325 cases of hyperthyroidism treated with radioiodine in Japan from 1953 to 1967. Of these cases, there were 1,892 which clearly had or had not received thyroid hormone substitution therapy. Based on this, the frequency, period of onset and back-ground of patients of hypothyroidism were investigated. There was a high incidence of cases among women in their thirties who had received large doses of radioiodine. Also, consistent with previous reports, a continuous, long-term increase in hypothyroidism was recognized. There is a need to investigate the course of the disease more thoroughly. The outbreak of thyroid tumors was also investigated. No clear increase in the incidence of tumors was seen in cases that had received radio-iodine therapy. An evaluation of prognosis was made to establish the anticipated mortality rate using the mortality rate of the population at large as a base for comparison. In the 2,379 cases in which there was an effective response, no significant increase in either mortality or cancer mortality was recognized in the group that received radioiodine therapy. Nor was there an increase in the mortality rate among the younger patients in the treated group. Although there was a tendency for the overall mortality to increase when large quantities of radio-iodine were prescribed. There is, however, some uncertainty as to whether or not there is a direct relationship to hypothyroidism. From this stand-point, rigorous observation during the course of treatment is important as well as commencement of appropriate substitution therapy.
PracticeClinical medicine
KeywordsHyperthyroidism, Radioiodine therapy, Late-onset hypothyroidism, Thyroid tumor, mortality.

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