左甲状腺素片联合碘-131治疗分化型甲状腺癌术后患者的临床研究

Clinical trial of levothyroxine sodium tablets combined with iodine-131 in the treatment of patients with postoperative differentiated thyroid cancer

目的研究左甲状腺素片联合碘-131治疗分化型甲状腺癌术后患者的疗效及安全性。方法将85例分化型甲状腺癌患者随机分为试验组45例和对照组40例。2组入院后均择期行甲状腺全切术,术后4周时给予碘-131,对照组在此基础上给予常规甲状腺素替代治疗,甲状腺片,初始剂量10~20 mg·d^-1,逐渐增加剂量,之后维持于40~120 mg·d^-1;试验组给予左甲状腺素片口服治疗,剂量75~150μg·d^-1,持续用药1个月。比较2组的临床疗效、血清促甲状腺素(TSH)、白细胞分化抗原44变异型6(CD44V6)、可溶性白细胞介素-2受体(sIL-2R)和血管内皮生长因子(VEGF)的水平,并观察药物不良反应(ADR)发生率。结果治疗后,试验组和对照组的总有效率分别为93.33%和77.50%;这2组的血清TSH分别为(1.32±0.28)和(0.17±0.04)mU·L^-1;这2组的CD44V6分别为(309.01±26.37)和(347.50±31.34)ng·mL^-1;这2组的sIL-2R分别为(355.52±27.40)和(402.64±34.01)μg·mL-1;这2组的VEGF分别为(13.02±1.72)和(19.40±2.05)pg·mL^-1。上述指标组间比较差异均有统计学意义(均P<0.05)。试验组和对照组的总ADR发生率分别为20.00%和20.00%,组间比较差异无统计学意义(P>0.05)。结论左甲状腺素片联合碘-131对分化型甲状腺癌患者术后治疗效果显著,可明显降低血清CD44V6、sIL-2R和VEGF的表达,且安全性好。

Objective To study the efficacy and safety of levothyroxine sodium tablets combined with iodine-131 in the treatment of patients with postoperative differentiated thyroid cancer.Methods Eighty-five cases of differentiated thyroid cancer who received therapy were divided into two groups:with 45 cases in the treatment group and 40 cases in the control group.The two groups were selected to undergo total thyroidectomy,and they were treated with iodine-131 in 4 weeks after total thyroidectomy;on this basis,the control group was given conventional thyroxine replacement therapy,thyroid tablet,the initial dose of 10-20 mg·d^-1 was gradually increased,and then maintained at 40-120 mg·d^-1;the treatment group was treated with levothyroxine sodium tablets,75-150μg·d^-1 for 1 month.The clinical efficacy,levels of serum thyrotropin(TSH),cluster of differentiation 44 variant 6(CD44V6),soluble interleukin-2 receptor(sIL-2R)and vascular endothelial growth factor(VEGF)were determined.And adverse drugs reaction(ADR)were compared between the two groups.Results After treatment,the total effective rates in treatment group and control group were 93.33% and 77.50%,respectively;the serum TSH in the two groups were(1.32±0.28)and(0.17±0.04)mU·L^-1;the CD44V6 in the two groups were(309.01±26.37)and(347.50±31.34)ng·mL^-1,respectively;the sIL-2R in the two groups were(355.52±27.40)and(402.64±34.01)μg·mL-1,respectively;the VEGF in the two groups were(13.02±1.72)and(19.40±2.05)pg·mL^-1,the difference of the factors between the two groups were significant(all P<0.05).The total incidence of ADR in treatment group and control group was 20.00% and 20.00% without significant difference(P>0.05).Conclusion Levothyroxine sodium tablets combined with iodine-131 is well for postoperative differentiated thyroid cancer,which can effectively down regulated the expression of serum CD44V6,sIL-2R and VEGF,and has good safety.