摘要： 目的 探讨131I治疗Graves’病患者转归的直接影响因素。 方法 302例Graves’病患者接受131I治疗，治疗前做吸碘试验，治疗前和治疗三年后各抽血一次，检测血清T3、T4、FT3、FT4、s-TSH、TRAb、TPOAb。依据治疗三年后甲状腺功能情况分为：复发组、治愈组、甲减组，并对三组患者年龄、性别、治疗剂量、治疗前吸碘率、T3、T4、FT3、FT4、s-TSH、TRAb、TPOAb等因素进行比较。结果 患者性别、治疗前吸碘率、血清T3、T4、FT3、FT4、s-TSH比较，各组之间差异无统计学意义（P＞0.05）；甲减组年龄低于复发组（P﹤0.05）；复发组131I治疗剂量高于治愈组（P＜0.05）；治愈组TRAb高于甲减组（P＜0.05）；治疗前血清TPOAb比较，甲减组最高，治愈组次之，复发组最低，三者之间有明显差异（P＜0.01）。 结论 患者年龄、131I治疗剂量、血清TRAb、TPOAb等因素与Graves’病131I治疗后的转归有一定的关系。患者年龄低的容易发生甲减。少数严重的Graves’病患者尽管治疗剂量大仍难治愈且易复发。治疗前TRAb低的患者容易发生甲减，TPOAb越高，越易发生甲减。

Abstract: Objective Find out the direct influencing factors for the treatment of the Graves’disease by 131I. Method 302 patients with Graves disease were treated with 131I.An Iodine absorption test had been done before the treatment. Before and three years after the treatment,patients' different serum factors such as T3, T4, FT3, FT4, s-TSH, TRAb and TPOAb were detected. According to their thyroid functions 3 years after treatment,patients were divided into 3 groups as follows: relapse group, cured group and hypothyroidism group. Age, gender, therapeutic dose, Iodine absorption efficiency, T3, T4, FT3, FT4, s-TSH, TRAb and TPOAb were compared among the 3 groups.Results For factors as gender, Iodine absorption efficiency, blood serums T3, T4, FT3, FT4 and s-TSH, there were no statistical differences among the 3 groups(P > 0.05).Age of hypothyroidism group was lower than that of relapse group（P<0.05）. 131I therapeutic dose of relapse group was higher than that of cured group （P<0.05）.TRAb of cured group was higher than that of hypothyroidism group (P < 0.05).For serum TPOAb before treatment,hypothyroidism group was the highest,relapse group was the lowest,while cured group was in between, there were statistical differences (P < 0.01) among the 3 groups. Conclusion Age, 131I therapeutic dose, blood serum TRAb and TPOAb had something to do with the prognosis of Graves' disease treated by 131I. Hypothyroidism was inclined to younger patients.A few serious patients could not be cured or relapsed easily even though a much higher therapeutic dose was used.Patients with lower TRAb and higher TPOAb before treatment were also prone to hypothyroidism.