I规范化治疗甲亢课件.pptx

1、2022-12-2712022-12-2722022-12-2732022-12-274 2022-12-275甲状腺毒症甲状腺毒症甲亢（甲亢（T3/T4产生过多）产生过多）甲炎（甲炎（T3/T4渗透入血）渗透入血）外源性（医源性或误食）外源性（医源性或误食）甲亢甲亢甲状腺功能增强，产生过多甲状腺功能增强，产生过多T3、T42022-12-2762022-12-2772022-12-278 2022-12-2792022-12-27102022-12-27112022-12-27122022-12-27132022-12-27142022-12-27152022-12-27162022-12-

2、27172022-12-27182022-12-27192022-12-27202022-12-2721甲巯咪唑甲巯咪唑（分子量小）（分子量小）丙基硫氧嘧啶丙基硫氧嘧啶（分子量大）（分子量大）2022-12-2722 2022-12-27232022-12-272472.5%2022-12-2725050100150200300)250350Mayuree Homsanit,et al.Efficacy of single daily dosage of methimazole vs.propylthiouracil in the induction of euthyroidism.Clini

3、cal Endocrinology.2001;54:385-390*PTU2022-12-2726024681012 Mayuree Homsanit,et al.Efficacy of single daily dosage of methimazole vs.propylthiouracil in the induction of euthyroidism.Clinical Endocrinology.2001;54:385-390 PTU*2022-12-2727K Okamura,et al.Reevaluation of the effects of methylmercaptoim

4、idazole and propylthiouracil in patients with Graves hyperthyroidism.J Clin Endocrinol Metab.1987;65(4):719-23 2022-12-2728摘自：罗清礼主编甲状腺相关眼病 人民卫生出版社第一版 2005；PP26-582022-12-27292022-12-27302022-12-27312022-12-27322022-12-27332022-12-27342022-12-27352022-12-27362022-12-27372022-12-27382022-12-27392022-1

5、2-27402022-12-27412022-12-2742 2022-12-27432022-12-27442022-12-27452022-12-27462022-12-27472022-12-27482022-12-27492022-12-27502022-12-27512022-12-27522022-12-27532022-12-2754 2022-12-27552022-12-27562022-12-27572022-12-27582022-12-27592022-12-27602022-12-2761核医学内分泌2022-12-2762131I治疗GD的禁忌证妊娠和哺乳期妇女核医

6、学内分泌2022-12-27632022-12-2764中华医学会内分泌临床技术操作规范2022-12-2765中华医学会内分泌临床技术操作规范2022-12-2766 131I的生物学作用特点的生物学作用特点 131I 主要蓄积在甲状腺内,其余多由尿排出,其他脏器的吸收剂量很小 甲功正常成人131I 370 MBq(10mCi)后脏器吸收剂量(rads,RAIU25%)脏器 MIRD ICRP Oak Ridge 损伤剂量和效应 (1975)(1987)(1996)(rads)甲状腺 13 000.00 13320.00 13000.00 红骨髓 2.60 2.60 3.10 1次600,可

7、再生 卵巢 1.40 1.60 1.80 500-1000,不育 睾丸 0.88 0.99 1.00 500-1000,不育 肝脏 4.80 1.30 3.90 3000,放射性肝炎 胃壁 14.00 17.0 13.0 1500/10天,无损伤 肾脏 -2.10 1.30 2000,放射性肾炎 全身 7.10 -100,WBC减少 MIRD.J Nucl Med,1975,16:857-860 ICRP Publications 53.1987,18(1-4)Stabin MG.ORISE Publication,April 30,19962022-12-2767 2022-12-27682022-12-27692022-12-27702022-12-27712022-12-27722022-12-2773 2022-12-27742022-12-27752022-12-27762022-12-27772022-12-27782022-12-2779 2022-12-27802022-12-27812022-12-27822022-12-27832022-12-27842022-12-2785 2022-12-27862022-12-27872022-12-27882022-12-27892022-12-2790