采用TSH抑制疗法对分化型甲状腺癌患者术后骨密度及骨代谢标志物的影响

Effects of TSH inhibition on bone mineral density and bone metabolic markers in patients with differentiated thyroid cancer

目的研究采用促甲状腺激素(thyroid-stimulating hormone,TSH)抑制疗法对分化型甲状腺癌患者术后骨密度及骨代谢标志物的影响。方法随机选取2015年4月-2016年4月于我院行手术且留存病灶标本的80例分化型甲状腺癌患者作为研究对象,全部患者采用TSH抑制疗法;选取同期体检的健康人群50位作为健康组,比较两组研究对象的骨代谢指标与股骨和腰椎不同椎体的骨密度状况。结果研究组患者的骨代谢指标β-胶原特殊序列与总I型胶原氨基酸延长肽比健康组明显升高,差异有统计学意义(P<0.05);研究组患者的股骨颈和髋关节的骨密度比健康组明显减少,差异有统计学意义(P<0.05);两组患者的腰椎不同椎体的骨密度没有统计学差异(P>0.05)。结论术后TSH抑制疗法在治疗分化型甲状腺癌患者过程中能够提高机体的骨转换状况,同时会减少机体股骨颈和髋关节的骨密度,因此在临床中分化型甲状腺癌患者术后采用TSH抑制疗法应警惕骨质疏松的形成。

Objective To investigate the effects of thyroid-stimulating hormone(TSH)inhibition onbone mineral density and bone metabolic markers in patients with differentiated thyroid cancer.Methods A totalof80patients with differentiated thyroid cancer in our hospital from April2015to April2016who underwentsurgery and retained the focus specimen were selected as the research object.All patients received thyrotropinsuppression therapy.50healthy people were selected as healthy group.The bone metabolic markers and bonemineral density of the femoral and lumbar vertebrae were compared between the two groups.Results The bonemetabolism index(collagen specific sequence and total type I collagen amino acid peptide)of the study groupwas significantly higher than that of the healthy group,and the difference was statistically significant(P<0.05).The bone mineral density of the femoral neck and hip joint in the study group was significantly lower than thatin the healthy group,and the difference was statistically significant(P<0.05).There was no significant differencein bone mineral density of lumbar vertebrae between the two groups(P>0.05).Conclusion Postoperative TSHsuppression therapy in the treatment of differentiated thyroid cancer patients can improve the body's bone turnover,also reduce the body's bone mineral density of the femoral neck and hip joint.Therefore,patients with differentiatedthyroid cancer after the implementation of thyroid hormone suppression therapy should be alert tothe formation of osteoporosis.