^(131)I联合左旋甲状腺素对分化型甲状腺癌术后患者骨代谢的影响

Effect of combination of ^(131)I and L-thyroxin on bone metabolism in patients with differentiated thyroid carcinoma after surgery

观察^(131)I联合左旋甲状腺素(LT4)替代治疗或抑制治疗对120例分化型甲状腺癌(DTC)术后患者部分骨代谢生化指标及骨密度的影响。替代组、抑制组与健康对照组血钙、血磷、血碱性磷酸酶(ALP)、骨密度(BMD)的差异无统计学意义,不同^(131)I累积剂量组间血钙、血磷、ALP、BMD的差异亦无统计学意义。观察期内所有患者无一例发生骨折。对DTC术后患者给予^(131)I联合替代或抑制剂量的LT4治疗是安全和必要的,该策略在短期内不会引起骨代谢生化指标和BMD的明显异常。

[ Summary] The effects of combination of ^131 I and suppressive or replacing doses of L-thyroxine （ LT4 ） on bone metabolism in 120 post-operative patients with differentiated thyroid carcinoma （DTC） were observed. Serum FT3, FT4, TSH, PTH, serum calcium, serum phosphate, serum alkaline phosphatase levels and bone mineral density （BMD） were measured in 120 patients, who had received LT4 for 2-5 years. No significant differences were detected in BMD and biochemical indexes of bone metabolism in the subjects compared with the healthy control group. No significant differences were found in the results according to dose accumulation of ^131 I. No fracture was found in these patients. The combination of ^131 I and suppressive or replacing doses of LT4 is safe and necessary for patients with DTC after surgery. The treatment for 2-5 years is not associated with increased risk of osteoporosis.