TSH抑制治疗对甲状腺癌患者根治术后甲状腺功能及远期预后的影响

Effect of TSH Suppression Therapy on Thyroid Function and Long-term Prognosis of Patients with Thyroid Cancer After Radical Resection

目的:分析TSH抑制治疗对甲状腺癌根治术后患者甲状腺功能改变及远期预后的影响。方法:收集2018年1月—2020年1月于本院诊断并行手术治疗的96例甲状腺癌患者为研究对象,依据术后用药方案不同分为对照组和观察组,各48例。观察组予以TSH抑制治疗,对照组则接受甲状腺激素替代疗法,比较两组治疗后不同时间段甲状腺功能状态、肿瘤基因、骨密度及心血管病变风险,并统计2年后复发率。结果:观察组治疗后6个月、12个月时FT_(3)、FT_(4)高于对照组,差异有统计学意义(P<0.05);观察组治疗12个月STAT3阳性率表达低于对照组,差异有统计学意义(P<0.05)。观察组治疗前及治疗6个月后SDNN比较,差异无统计学意义(P>0.05);观察组治疗后12个月SDNN小于对照组,差异有统计学意义(P<0.05);两组治疗后各时间段骨密度比较,差异无统计学意义(P>0.05)。两组复发率比较,差异无统计学意义(P>0.05)。结论:甲状腺癌患者在根治术后应用TSH抑制治疗能较好地维持甲状腺功能,降低肿瘤复发风险,但增加了心律失常风险。

Objective:To analyze the effect of TSH suppression therapy on thyroid function changes and long-term prognosis of patients with thyroid cancer after radical resection.Methods:A total of 96 patients with thyroid cancer who were diagnosed and treated in our hospital from January 2018 to January 2020 were enrolled in the study.According to the different postoperative medication regimens,they were divided into control group and observation group,with 48 cases in each group.The observation group was treated with TSH suppression,and the control group was treated with thyroid hormone replacement therapy.The thyroid function status,tumor gene,bone mineral density and cardiovascular disease risk at different time points after treatment in the two groups were compared,and the recurrence rate after 2 years was counted.Results:FT3 and FT4 in the observation group were higher than those in the control group at 6 months and 12 months after treatment,and the difference was statistically significant(P<0.05).The positive expression of STAT3 in the observation group after 12 months of treatment was lower than that in the control group,and the difference was statistically significant(P<0.05).There was no significant difference in SDNN before treatment and 6 months after treatment in the observation group(P>0.05).SDNN in the observation group was smaller than that in the control group 12 months after treatment,and the difference was statistically significant(P<0.05).There was no significant difference in bone mineral density between the two groups at each time point after treatment(P>0.05).There was no significant difference in the recurrence rate between the two groups(P>0.05).Conclusion:TSH inhibition therapy in patients with thyroid cancer after radical surgery can better maintain thyroid function,reduce the risk of tumor recurrence,but increase the risk of arrhythmia.