在患有格雷夫斯病的患者接受放射性治疗后,评估原发性副甲状腺炎症
Sarah J H Melin1, Sarah Y Park1, Joseph Shaker2
1Division of Surgical Oncology, Department of Surgery, Medical College of Wisconsin, Milwaukee, WI.
Surgery
|September 10, 2024
概括
对格雷夫斯病的放射性治疗可能会增加高血症的风险. 许多患者没有充分评估原发性副甲状腺功能障碍症,导致诊断不足. 在放射性治疗后,建议定期查.
科学领域:
- 内分泌学 在内分泌学.
- 核医学是一种核医学.
- 手术瘤学手术瘤学
背景情况:
- 关于放射性 (RAI) 治疗后的原发性副甲状腺功能障碍风险存在相互矛盾的回顾性数据.
- 假设:与甲状腺切除术相比,RAI增加了原发性甲状腺功能障碍症的发生率.
- 在格雷夫斯病治疗后患有高血症的患者可能被诊断为原发性副甲状腺功能障碍症.
研究的目的:
- 为了比较RAI后的原发性副甲状腺功能障碍率与Graves病的甲状腺切除术.
- 评估对因格雷夫斯病治疗的患者高血症评估的充分性.
主要方法:
- 900名格雷夫斯病患者接受RAI或甲状腺切除术治疗的回顾性审查 (2000-2022年).
- 排除标准:先前的头部/部辐射,原发性副甲状腺功能障碍,功能障碍或组合治疗.
- 根据和副甲状腺激素水平,高血症的评估被分类为"不完整的治疗","可能的原发性副甲状腺症"或"不可能的原发性副甲状腺症".
主要成果:
- 在RAI (10%) 后,高血症发生的频率高于甲状腺切除术 (6%).
- 在患有高血症的患者中,63%的检查不完整,10%的患者可能患有原发性甲状腺功能障碍,27%的患者不太可能.
- 在RAI和甲状腺切除组之间,初级甲状腺功能障碍症恢复率没有显著差异.
结论:
- 对格雷夫斯病的RAI治疗与高血症的更高率有关.
- 在这些患者中,对原发性甲状腺功能障碍症的不充分评估是常见的.
- 定期检查和适当的治疗对于接受RAI治疗的患者至关重要.
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