TSH抑制治疗对甲状腺癌患者根治术后甲状腺功能的影响

Effect of TSH Inhibition Therapy on Thyroid Function After Radical Surgery in Patients With Thyroid Cancer

目的探讨受促甲状腺激素(thyroid stimulating hormone,TSH)抑制治疗对甲状腺癌患者根治术后甲状腺功能的影响。方法 选取2019年1月—2022年1月山东潍坊阳光融和医院收治的甲状腺癌根治术病患137例。以抽签法将其分为两组,参照组68例,接受甲状腺激素替代疗法干预,试验组69例,均接受促甲状腺激素(thyroid stimulating hormone,TSH)抑制治疗。评析两组甲状腺功能及预后情况。结果 干预前,两组甲状腺功能、信号转导和转录激活因子3(acutephase response factor 3,STAT3)阳性表达率、心率变异性、骨密度指标等比较,差异无统计学意义(P> 0.05)。干预后,试验组TSH、T_(4)、T_(3)水平低于参照组,FT_(4)、FT_(3)高于参照组,差异有统计学意义(P <0.05)。干预12个月后,试验组STAT3阳性表达率、心率变异性等均低于参照组,差异有统计学意义(P <0.05)。干预12个月后,试验组复发率为7.24%,参照组为13.23%(P> 0.05);两组存活率比较,差异无统计学意义(P> 0.05)。结论 甲状腺癌患者根治术后予以TSH抑制治疗方案,对改善患者甲状腺功能意义显著,有助于降低疾病复发的风险,预后效果良好,但是存在增加心律失常发生的可能性。

Objective To explore the effect of thyroid stimulating hormone(TSH)inhibition therapy on thyroid function after radical surgery in patients with thyroid cancer.Methods From January 2019 to January 2022,a total of 137 patients with thyroid cancer underwent radical operation in Weifang Yangguang Ronghe Hospital were selected.The TSH inhibitory treatment was given to 69 patients in the experimental group.TSH inhibitory treatment was given to 68 patients in the reference group.Thyroid function and prognosis of two groups were evaluated.Results Before intervention,there was no statistical value in thyroid function,acute phase response factor 3(STAT3)positive expression rate,heart rate variability and bone mineral density in two groups(P>0.05).After intervention,the levels of TSH,T4 and T3 in experimental groups were lower than those in the reference group,while FT_(4) and FT_(3) in experimental groups were higher than those in the reference group,and there was a difference between groups(P<0.05).After 12 months of intervention,STAT3 positive expression rate and heart rate variability in experimental group were lower than those in the control group,and the difference between groups was significant(P<0.05).After 12 months of intervention,the recurrence rate of the experimental group was 7.24%and that of the control group was 13.23%(P>0.05),and the survival rate of the two groups was not statistically significant(P>0.05).Conclusion After radical surgery for thyroid cancer patients,TSH inhibition therapy has significant significance in improving thyroid function and helping to reduce the risk of disease recurrence.The prognosis effect is good,but there is a possibility of increasing arrhythmia.