抑制剂量甲状腺激素对分化型甲状腺癌术后患者甲状腺功能及骨骼系统风险的影响

Effects of Inhibitory Dose TSH on Thyroid Function and Skeletal System Risk in Patients with Differentiated Thyroid Carcinoma after Surgery

目的:探究抑制剂量促甲状腺激素(TSH)对分化型甲状腺癌术后患者甲状腺功能及骨骼系统风险的影响。方法:本研究以随机对照的临床研究方法,选择2019年7月—2020年7月深圳市盐田区人民医院收治的符合纳入标准的50例分化型甲状腺癌患者为观察对象,通过计算机随机数字分配原则,将其分为对照组与实验组,每组各25例。两组患者均给予甲状腺癌根治切除手术治疗,对照组中患者给予常规剂量TSH治疗,实验组患者给予抑制剂量TSH治疗,观察两组采用不同TSH治疗后甲状腺功能改善效果以及降低骨骼系统不良事件发生的风险。结果:与治疗前对比,治疗后两组患者FT4、FT3水平提高,TSH明显降低,差异有统计学意义(P<0.05)。两组患者治疗前后ALP、磷、钙对比差异无统计学意义(P>0.05)。实验组不良事件发生率低于对照组,差异有统计学意义(P<0.05)。结论:采用对DTC术后患者实施抑制剂量TSH治疗,不仅可以补足甲状腺激素的生理需要量,还可以降低癌灶增殖风险、降低骨骼系统不良事件发生风险。

Objective:To explore the influence of inhibitory dose TSH on thyroid function and skeletal system risk in patients with differentiated thyroid cancer after surgery.Methods:Based on the randomized controlled clinical research method,50 patients with differentiated thyroid cancer who met the inclusion criteria and were admitted to the hospital from July 2019 to July 2020 were selected as observation objects,25 cases in each group.According to the computer random number allocation principle,they were divided into control group(n=25)and experimental group(n=25).Patients in both groups were treated with radical resection of thyroid cancer,patients in the control group were treated with conventional doses of TSH,and patients in the experimental group were treated with inhibitors of TSH.The effects of improving thyroid function and reducing the risk of adverse events in the skeletal system after the two groups treated with different TSH were observed.Results:Compared with before treatment,the levels of FT4 and FT3 in the two groups increased and TSH significantly reduced after treatment,with statistically significant differences between the two groups(P<0.05).There was no statistically significant difference in ALP,phosphorus and calcium between the two groups before and after treatment(P>0.05).The incidence of adverse events in the experimental group was lower than that in the control group,with statistically significant difference(P<0.05).Conclusion:TSH therapy can not only make up the physiological requirement of thyroid hormone,but also reduce the risk of tumor proliferation and skeletal system adverse events after DTC operation.