分化型甲状腺癌患者促甲状腺激素抑制治疗期间骨质疏松风险筛查及影响因素分析

Screening of osteoporosis risk in patients with differentiated thyroid cancer during thyroid stimulating hormone inhibition therapy and its influencing factors

目的了解分化型甲状腺癌患者术后长期行促甲状腺激素(TSH)抑制治疗期间骨质疏松风险,并探索其相关影响因素。方法选取接受分化型甲状腺癌术后行TSH抑制治疗的300例患者为研究对象,利用国际骨质疏松基金会骨质疏松一分钟测试法和亚洲人骨质疏松自我筛查工具(OSTA)进行骨质疏松风险筛查,并根据结果进行影响因素分析。结果300例接受分化型甲状腺癌术后行TSH抑制治疗的患者中,66.00%的患者存在骨质疏松风险;OSTA显示该组患者骨质疏松低度风险为96.00%,中度风险为1.00%,高度风险为3.00%。患者的服药剂量、性别、绝经、婚姻状况、医保支付类型以及是否知晓甲状腺癌术后激素治疗会增加骨质疏松的发病率是骨质疏松的影响因素。结论大部分分化型甲状腺癌TSH抑制治疗患者都存在患有骨质疏松的风险,但多为低度风险。患者对骨质疏松的防范意识普遍不高。

Objective To investigate the risk of osteoporosis in patients with differentiated thyroid cancer during longterm thyroid stimulating hormone inhibition after surgery and explore its related influencing factors.Methods Totally 300 patients who received thyroid stimulating hormone inhibition therapy were enrolled as the research subject.The international osteoporosis foundation osteoporosis a minute test and the Asian osteoporosis screening tool(OSTA)screening were used to screen the risk of osteoporosis.And its influencing factors were analyzed by logistic regression.Results Among 300 patients with differentiated thyroid cancer who received thyroid stimulating hormone inhibition therapy,66.00%of them were at risk of osteoporosis.OSTA showed that the low risk,moderate risk and high risk of osteoporosis in this group were 96.00%,1.00%,and 3.00%respectively.The dose of medication,sex,menopause,marital status,type of medical insurance payment,and knowledge that hormone therapy after thyroid cancer were the risk factors of osteoporosis.Conclusion Most patients with differentiated thyroid cancer treated with thyroid stimulating hormone inhibition have a low risk of osteoporosis.The prevention awareness of osteoporosis in patients is generally not high.