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目的:构建竞争风险模型预测n 131I治疗格雷夫斯病(GD)出现未愈或甲状腺功能亢进症(简称甲亢)复发的累积风险概率。n 方法:纳入2020年1月至2021年5月在福建医科大学附属漳州市医院接受n 131I治疗的GD患者61例[男13例，女48例，年龄(46.0±13.8)岁]。治疗结局分为痊愈、未愈或甲亢复发(事件1)及甲状腺功能减退症(简称甲减；事件2)。治疗1个月后开始随访，最长随访1年。随访终止有以下情况：出现2个事件之一；满1年未出现事件；研究截止时间终止。Fine-Gray检验分析筛选与事件1相关的因素并建立竞争风险模型。n 结果:治疗后39例患者出现甲减，17例未愈或甲亢复发，2例失随访，3例甲状腺功能正常。多因素竞争风险分析显示，有效半衰期[风险比(n HR)＝1.74，95% n CI: 1.10~2.75, n β＝0.55, n P＝0.019]及甲状腺容积(n HR＝1.12，95% n CI: 1.07~1.17, n β＝1.12, n P<0.001)是事件1的危险因素，而甲状腺弹性值为事件1的保护因素(n HR＝0.17，95% n CI: 0.06~0.54, n β＝-1.76, n P＝0.003)。基于多因素竞争风险模型构建的列线图C指数为0.784(95% n CI: 0.633~0.935)。n 结论:甲状腺容积、甲状腺弹性值及有效半衰期与治疗结局相关，竞争风险模型可以预测GD患者的治疗结局。“,”Objective:To establish a competing risk model to predict the cumulative hazard risk probability of the outcomes (unhealed or hyperthyroidism recurrence) of Graves disease (GD) treated with n 131I.n Methods:From January 2020 to May 2021, 61 GD patients (13 males, 48 females; age (46.0±13.8) years) who received n 131I treatment in Zhangzhou Affiliated Hospital of Fujian Medical University were enrolled. The outcomes of treatment were recovery, unhealed or hyperthyroidism recurrence (event 1), and hypothyroidism (event 2). Follow-up was started 1 month after n 131I treatment and ended 1 year later. It was terminated in the following conditions: one of the two events occurred; no event occurred after 1 year of follow-up; the research deadline was up. The Fine-Gray test was used to analyze the factors related to event 1, and then the competitive risk model was established.n Results:Thirty-nine patients had hypothyroidism, 17 patients were unhealed or had hyperthyroidism recurrence, 2 patients lost follow-up, and 3 patients had normal thyroid function after 1 year follow-up. Multivariate analysis showed that effective half-life (hazard ratio (n HR)=1.74, 95% n CI: 1.10-2.75, n β=0.55, n P=0.019) and thyroid volume (n HR=1.12, 95% n CI: 1.07-1.17, n β=1.12, n P<0.001) were risk factors for event 1, while the elasticity of thyroid was a protective factor (n HR=0.17, 95% n CI: 0.06-0.54, n β=-1.76, n P=0.003). The C index of the nomogram constructed based on the multi-factor competitive risk model was 0.784(95% n CI: 0.633-0.935).n Conclusions:Thyroid volume, elastic value, and effective half-life are associated with treatment outcomes of n 131I. The competitive risk model can predict the therapeutic outcomes of GD patients treated with n 131I.n