TSH抑制疗法对分化型甲状腺癌患者术后血清Tg、VEGF、TSGF、CD44V6、sIL-2R及T淋巴细胞亚群水平的影响

Effects of TSH inhibition after total thyroidectomy on Tg,VEGF,TSGF,CD44V6,sIL-2R and T lymphocyte subsets in patients with differentiated thyroid carcinoma

目的:探讨促甲状腺激素(thyroid stimulating hormone,TSH)抑制疗法对分化型甲状腺癌(differentiated thyroid carcinoma,DTC)患者术后血清甲状腺球蛋白(thyroglobulin,Tg)、血管内皮生长因子(vascular endothelial growth factor,VEGF)、肿瘤特异性生长因子(tumors pecific growth factor,TSGF)、白细胞分化抗原44变异型6(CD44V6)、可溶性白细胞介素-2受体(soluble interleukin-2receptor,sIL-2R)及T淋巴细胞亚群水平的影响。方法:选择2014年1月~2017年1月我院收治的接受甲状腺全切手术治疗的100例DTC患者,随机分为对照组和实验组,各50例。对照组患者常规给予甲状腺素替代治疗,实验组患者给予TSH抑制疗法(口服左甲状腺素钠片,控制血清TSH水平低于0.1mU/L),两组患者均给予治疗1个月。比较两组患者治疗前后血清Tg、VEGF、TSGF、CD44V6、sIL-2R水平及外周血CD3^+、CD4^+、CD8^+水平。结果:两组治疗前的血清Tg、VEGF、TSGF、CD44V6、sIL-2R水平比较,均无显著性差异(P>0.05);两组治疗后的血清Tg、VEGF、TSGF、CD44V6、sIL-2R水平相比治疗前均较低,且实验组治疗后血清Tg、VEGF、TSGF、CD44V6、sIL-2R水平变化均显著优于对照组(P<0.05)。两组治疗前的外周血CD3^+、CD4^+、CD8^+水平比较,均无显著性差异(P>0.05);两组治疗后的外周血CD3^+、CD4^+水平相比治疗前均较高、CD8^+水平相比治疗前均较低,且实验组治疗后血外周血CD3^+、CD4^+、CD8^+水平变化均优于对照组,具有显著性差异(P<0.05)。结论:DTC行甲状腺全切手术治疗后接受TSH抑制疗法能够有效降低血清Tg、VEGF、TSGF、CD44V6、sIL-2R水平,改善细胞免疫功能,值得在临床上推广应用。

Objective:To study the effects of TSH inhibition after total thyroidectomy on Tg,VEGF,TSGF,CD44V6,sIL-2Rand T lymphocyte subsets in patients with differentiated thyroid carcinoma(DTC).Methods:A total of 100patients with DTCin our hospital from January 2014to January 2017were enrolled in this study.The subjects were divided into the control group(n=50)and the treatment group(n=50)randomly.The control group were treated with thyroid hormone replacement therapy,the treatment groupwere treated with levothyroxine sodium oral therapy,the two groups were treated for1week.The serum Tg,VEGF,TSGF,CD44V6,sIL-2Rand peripheral blood CD3^+,CD4^+,CD8^+of the two groups before and after treatment were compared.Results:There were no significantly differences of the serum Tg,VEGF,TSGF,CD44V6,sIL-2Rof the two groups beforetreatment(P>0.05).The serum Tg,VEGF,TSGF,CD44V6,sIL-2Rof the two groups after treatment were significantly lower than before treatment(P<0.05),and that of the treatment group after treatment were significantly lower than the control group(P<0.05).There were no significantly differences of the peripheral blood CD3^+,CD4^+,CD8^+of the two groups beforetreatment(P>0.05).The peripheral blood CD3^+,CD4^+of the two groups after treatment were significantly higher than before treatment(P<0.05),the peripheral blood CD8^+of the two groups after treatment were significantly lower than before treatment(P<0.05),and that of the treatment group after treatment were significantly better than the control group(P<0.05).Conclusion:TSH inhibition after total thyroidectomy for patients with DTC can reduce the serum Tg,VEGF,TSGF,CD44V6,sIL-2Rlevels,improve the cellular immunity function,and it was worthy clinical application.