DTC患者术后首次行大剂量131I治疗中维生素E对腮腺功能的影响

Effect of Vitamin E on Parotid Function in DTC Patients Undergoing First Postoperative High-dose^(131)I Therapy

目的探讨术后首次大剂量131I治疗中,预先口服维生素E对腮腺的保护作用和对分化型甲状腺癌(differentiated thyroid cancer,DTC)患者腮腺功能的影响。方法选取2020年9月—2021年9月于牡丹江医学院附属红旗医院就诊的DTC术后患者40例,随机分为两组,A组为大剂量对照组,B组为大剂量观察组。B组的患者需于131I治疗前1周至131I治疗后1个月口服维生素E,A组不做特殊处理。对比131I治疗前后腮腺排泌分数(EF)、排泌率(ER)、摄取分数(UF)及摄取指数(UI)的变化。结果A组治疗后左腮腺ER值(51.09±5.62)%、EF值(51.78±5.77)%、右腮腺ER值(50.50±4.51)%及EF值(50.05±3.89)%均小于治疗前,差异有统计学意义(t=3.630、2.728、2.257、2.509,P<0.05);治疗前B组左右腮腺UI、UF值大于A组,差异有统计学意义(P<0.05)。结论DTC患者术后首次接受大剂量131I治疗时,可能会损伤腮腺功能的排泌功能,此时预先给予维生素E干预可以在一定程度上预防腮腺功能损伤。

Objective To investigate the effect of preemptive oral vitamin E on parotid gland protection during the first postoperative high-dose^(131)I treatment on parotid gland function in patients with differentiated thyroid cancer(DTC).Methods Forty postoperative patients with DTC who visited Hongqi Hospital affiliated with Mudanjiang Medical College from September 2020 to September 2021 were selected and randomly divided into two groups.Group A was a high-dose control group,while group B was a high-dose observation group.Patients in group B need to take vitamin E orally from 1 week before^(131)I treatment to 1 month after^(131)I treatment,and group A does not undergo special treatment.Compared the changes in parotid secretion score(EF),secretion rate(ER),uptake score(UF),and uptake index(UI)before and after^(131)I treatment.Results After treatment,the ER value(51.09±5.62)%,EF value(51.78±5.77)%,ER value(50.50±4.51)%,and EF value(50.05±3.89)%of the left parotid gland in group A were all lower than those before treatment,the difference was statistically significant(t=3.630,2.728,2.257,2.509,P<0.05).Before treatment,the UI and UF values of the left and right parotid glands in Group B were higher than those in Group A,and the difference was statistically significant(P<0.05).Conclusion The parotid gland function may be impaired when DTC patients receive high-dose^(131)I therapy for the first time after surgery,at this point,preemptive vitamin E intervention during the first high-dose^(131)I therapy after DTC can prevent parotid gland function impairment to a certain extent.