不同TSH抑制治疗对分化型甲状腺癌术后TSH、FT_(3)、FT_(4)的影响

Effect of Different TSH Inhibition Therapy on TSH,FT,FT in Differentiated Thyroid Carcinoma after Operation

目的:探讨不同促甲状腺激素(TSH)抑制治疗对分化型甲状腺癌术后TSH、游离三碘甲状腺原氨酸(FT_(3))、血清游离甲状腺素(FT_(4))的影响。方法:选取2018年8月-2019年2月本院收治的分化型甲状腺癌患者80例为观察对象,按随机数字表法将其分为对照组(n=40)与试验组(n=40),两组均给予甲状腺癌根治术治疗。术后,对照组给予常规剂量左旋甲状腺素治疗,试验组给予抑制剂量左旋甲状腺素治疗。比较两组治疗前后甲状腺功能、骨生化指标、心血管与骨骼系统不良事件发生及复发情况。结果:治疗后,试验组TSH低于对照组,FT_(3)、FT_(4)均高于对照组(P<0.05)。治疗后,两组血钙、血磷及碱性磷酸酶(alkaline phosphatase,ALP)比较,差异无统计学意义(P>0.05)。对照组心血管与骨骼系统不良事件发生率为17.50%,复发率为7.50%;试验组不良事件发生率为12.50%,复发率为5.00%,试验组心血管与骨骼系统不良事件与复发率稍低于对照组,但两组比较差异均无统计学意义(P>0.05)。结论:对分化型甲状腺癌术后患者实施抑制剂量左旋甲状腺素治疗,可改善甲状腺功能,且不良事件发生风险较低,临床应用价值显著。

Objective:To investigate the effects of different thyrotropin(TSH)inhibition therapy on TSH,free triiodothyronine(FT_(3))and serum free thyroxine(FT_(4))in differentiated thyroid carcinoma after operation.Method:A totsl of 80 patients with differentiated thyroid cancer admitted to our hospital from August 2018 to February 2019 were selected as the observation objects.According to random number table method,the patients were divided into control group(n=40)and experimental group(n=40),and both groups were treated with radical resection of thyroid carcinoma.After operation,the control group was treated with conventional dose of Levothyroxine,and the experimental group was treated with inhibitory dose of Levothyroxine.Thyroid function,bone biochemical indexes,cardiovascular and skeletal adverse events and recurrence were compared between the two groups before and after treatment.Result:After treatment,TSH in the experimental group was lower than that of the control group,and FT_(3)and FT_(4)in the experimental group were higher than those in the control group(P<0.05).After treatment,there was no significant difference in serum calcium,serum phosphorus and alkaline phosphatase(ALP)between the two groups(P>0.05).In the control group,the incidence of cardiovascular and skeletal adverse events was 17.50%,and the recurrence rate was 7.50%.The incidence of adverse events in the experimental group was 12.50%,and the recurrence rate was 5.00%.The cardiovascular and skeletal adverse events and recurrence rates in the experimental group were slightly lower than those in the control group,but there were no statistical significance between the two groups(P>0.05).Conclusion:Postoperative treatment with inhibitory dose Levothyroxine in patients with differentiated thyroid carcinoma can improve thyroid function,and the risk of adverse events is low,and the clinical application value is significant.