甲状腺手术切除范围对血降钙素水平的影响

EFFECTS OF EXCISION VOLUME ON CALCITONIN LEVEL OF PATIENTS WITH NON-MEDULLARY CARCINOMA

目的 :研究非髓样癌的甲状腺手术对血浆降钙素水平的影响。方法 :分别取入院后第 1天和术后第 1天清晨空腹静脉血 ,采用放免方法测CT和PTH ,并同时监测血钙、磷水平。结果 :术前CT平均值为 33.9pg/ml(0 .0 3～ 5 0 0pg/ml) ,术后第 1天CT平均值为 16 .6 pg/ml(1.88～ 12 1pg/ml) ,二者之间无显著性差异 (P =0 .35 0 )。术前PTH平均值为 2 7.2 pg/ml(9～ 4 5pg/ml) ,术后第 1天CT平均值为 2 4 .2 pg/ml(15 .5～ 37pg/ml) ,二者之间无显著性差异 (P =0 .2 15 )。其中 9例行一叶甲状腺全切和 (或 )对侧次全切除术的患者 ,他们术前CT平均值为 70 .6 pg/ml(3.75～ 5 0 0 pg/ml) ,术后第 1天CT平均值为 31.4pg/ml(4.0 6～ 12 1pg/ml) ,二者之间无显著性差异 (P =0 .384 )。术前PTH平均值为 2 6 .7pg/ml(9～ 4 5pg/ml) ,术后第 1天PTH平均值为2 7.4pg/ml(16 .6～ 37pg/ml) ,二者之间无显著性差异 (P =0 .816 )。 12例行一叶部分切除者术前、术后的CT和PTH同样无显著性差异 (P值分别为 0 .5 35和 0 .0 96 )。且以上两组病人术后第 1天CT值之间无显著性差异 (P >0 .0 1)。术前、术后的血中钙、磷浓度亦无显著性差异 (P值分别为 0 .0 2 2和 0 .5 5 2 )。结论

Objective:To evaluate the impact of calcitonin level and metabolism of calcium and phosphorus for postoperative patients with non-medullary thyroid carcinoma disease.Method:We collected the specimen of patients veinous blood in the peroperative and postoperative respectively.We measured the calcitonin (CT) ,parathyroid hormone (PTH) level using the radioimmunoassay, and examined the change of calcium, phosphorus of blood at the same time. Results:The median of CT were 33.9pg/ml (0.03～500pg/ml) in peroperative and 16.6pg/ml (1.88～121pg/mi) in the first day of postoperative,and no significant difference was found (P=0.350). The median of PTH were 27.2pg/ml (9～45pg/ml) in peroperative and 24.2pg/ml (15.5～37pg/ml) in postoperative,and no significant difference (P=0.215) was found. Nine cases performed lobectomy of thyroid total thyroidectomy or subtotal thyroidectomy; their median CT were 70.6pg/ml (3.75～500pg/ml) in peroperative and were 31.4pg/ml (4.06～121pg/ml) in postoperative;there was no significant difference (P=0.384). The median of PTH were 26.7pg/ml (9～45pg/ml) in peroperative and 27.4pg/ml (16.6～37pg/ml) in postoperative respectively. Twelve cases performed partial thyroidectomy,and their median of CT and PTH were not significantly different in peroperative and postoperative respectively (P=0.535,and 0.096). There were no significant difference (P>0.01) to CT and PTH in the two groups. The level of calcium and phosphorus of serum were not significantly different (P= 0.002, and 0.552) in peroperative and postoperative respectively. Conclusions:There are no impact to calcitonin level as volume of thyroidectomy for non-medullary thyroid carcinoma diseases.