促甲状腺素抑制治疗对分化型甲状腺癌患者术后左室收缩同步性的影响

Influence of TSH inhibition therapy on left ventricular systolic synchrony in patients with DTC

目的 探讨促甲状腺素（TSH）抑制治疗对分化型甲状腺癌（DTC）患者术后左室收缩同步性的影响.方法 选取2014年9月至2016年7月于郑州大学第一附属医院行TSH抑制治疗的分化型甲状腺癌术后患者35例作为实验组,在抑制治疗前及抑制治疗后6、12、24个月分别行门控心肌灌注显像,获得左室收缩同步性参数相角程、相位标准差和熵的数据,以同年龄组不需要TSH抑制治疗的分化型甲状腺癌患者28例为对照组,以年龄为协变量,采用SPSS 19.0软件对数据进行协方差检验,分析TSH抑制治疗对患者左室收缩同步性的影响.结果 实验组TSH抑制治疗后,随着时间的延长,相角程、相位标准差及熵均逐渐增加;在抑制治疗前及治疗后6、12个月时,实验组各指标与对照组比较差异未见统计学意义（P〉0.05）;抑制治疗后24个月时,两组相角程、相位标准差及熵比较差异均有统计学意义（P=0.006、0.007、0.001）.结论 长期TSH抑制治疗会影响患者的左室收缩同步性,门控心肌灌注显像可以观察早期收缩同步性的异常.

Objective To investigate the effects of thyroid stimulating hormone inhibition therapy on left ventricular systolic synchrony in patients with DTC .Methods A total of 35 patients with differentiated thyroid cancers who underwent thyroid stimulating hormone inhibition therapy in the first Affiliated Hospital of Zhengzhou University from September 2014 to July 2016 were selected as experimental group .Patients underwent gated myocardial perfusion imaging before and 6, 12 and 24 months after treatment , respectively , to collect phase shift , phase standard deviation , and entropy value of left ventricular systolic synchrony parameter .A total of 28 patients with differentiated thyroid cancer who did not require TSH inhibition therapy in the same age group were considered as control group .Data were tested for covariance by SPSS 19.0 with age as a covariate to analyze the effects of TSH inhibition on left ventricular systolic synchrony .Results After TSH inhibition treatment , the phase shift , phase standard deviation and entropy of experimental group gradually increased with time .However , there was no significant difference between experimental group and control group before and 6 , 12 months after inhibition .There were significant differences in phase shift , phase standard deviation , and entropy 24 months after treatment （P=0.006, 0.007, 0.001）.Conclusions Long-term TSH inhibition therapy can affect the left ventricular systolic synchrony of patients .Portal myocardial perfusion imaging can be used to observe the abnormality of early contractile synchrony .