摘要
目的研究远处转移灶对DTC患者停服L—T4（THW）后TSH升高速率（vx）及其随THW时间同比变化率（R6）的影响。方法收集2014年1月至2014年7月间清除甲状腺残余组织（简称清甲）成功的97例DTC患者[男38例，女59例；非远处转移（M。）组67例，远处转移（M，）组30例]THW前后多次（n≥3）TSH值，计算THw前期、后期vx（记为v1,v2），采用两样本t检验及秩和检验分析vx及Ra的影响因素。结果男性v1，高于女性[（3．58±2．13）与（2．63±1．54）mU·L-1·d-1；t=2．549，P=0．012]。M0组口2高于M1组[（7．67±3．66）与（3．68±4．33）mU·L-1·d-1；t=3．613，P=0．001]。2组患者TSH升高速率v1和v2的同比变化趋势（Ra）差异有统计学意义（z=4．17，P〈0．01）。结论远处转移灶会影响THW后TSH升高速率及其变化趋势。M1组停药后期TSH升高较M0组慢，并多呈缓慢升高趋势甚至出现下降；而M0组TSH多呈倍增上升趋势。伴有远处转移者需密切关注TSH变化，避免延长THW时间以致TSH下降、影响疗效。
Objective To investigate the influence of distant metastases on the increase rate （vx） of serum TSH and its change rate （ Ra ） in patients with DTC after thyroid hormone withdrawal （THW）. Methods Three times or more serum TSH measurements were performed before and after THW in 97 patients （38 males, 59 females） who had underwent successful 131I ablation from January 2014 to July 2014. v1 （ early period vX ）, v2（ later period vx ） and change rate of v1 and v2（ Ra ） were calculated and compared be- tween M0 group （without distant metastases, n= 67） and Ml group （with distant metastases, n = 30）. Two- sample t test and rank-sum test were used for statistical analysis. Results Vx in males was significantly higher than that in females （（3.58±2.13） vs （2.63±1.54） mU · L-1· d-1 ; t=2.549, P=0.012）. v2 in Mo group was significantly higher than that in M group （（7.67±3.66） vs （3.68±4.33） mU·L-1 · d-1 ; t= 3. 613, P=0.O01）. The difference of Ra between Mo group and M1 group was statistically significant（z=-4.17, P〈0.05）. Conclusions Distant metastases may affect the increase rate and its change pattern of serum TSH after THW. Serum TSH showed a slow elevation over time or even decline in patients with distant metastasis. Meanwhile TSH increased much higher over the THW time in most of the patients in M0 group. It was suggested that attention should be paid to the variation of serum TSH in DTC patients with distant metastases to avoid decrease of TSH during longer THW.
出处
《中华核医学与分子影像杂志》
北大核心
2015年第4期262-264,共3页
Chinese Journal of Nuclear Medicine and Molecular Imaging
基金
卫生部行业科研专项项目（201202012）
