不同剂量左甲状腺素钠片联合放射性^(131)I治疗对甲状腺癌术后患者的影响

Effects of Different Doses of Levothyroxine Sodium Tablets combined with Radioactive^(131)I Therapy on Patients with Thyroid Cancer after Surgery

目的探讨不同剂量左甲状腺素钠片联合放射性^(131)I治疗对甲状腺癌术后患者的影响。方法选取2021年8月至2022年8月遵义市第一人民医院收治的120例甲状腺癌患者作为研究对象,采用随机数字表法分为常规组和负荷组,各60例。两组甲状腺全切或近全切术后均接受放射性^(131)I治疗,常规组采用2.0μg/kg左甲状腺素钠片,负荷组采用2.5μg/kg左甲状腺素钠片。比较两组患者治疗前后血清甲状腺激素[游离三碘甲状腺素(FT_(3))、游离甲状腺素(FT4)、促甲状腺激素(TSH)、甲状腺过氧化物酶(TPO)]、免疫功能[CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)]、不良反应发生情况、预后情况。结果治疗后两组FT_(3)、FT4水平均升高,TSH、TPO水平均降低,且负荷组变化幅度大于常规组,差异有统计学意义(P<0.05);负荷组治疗后CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平高于常规组(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05);两组肿瘤复发率、转移率、死亡率比较差异无统计学意义(P>0.05)。结论2.5μg/kg剂量左甲状腺素钠片联合放射性^(131)I治疗甲状腺癌术后患者改善甲状腺激素水平效果更好,免疫功能更高,预后较好,安全性较高。

Objective To explore the effects of different doses of levothyroxine sodium tablets combined with radioactive^(131)I therapy on patients with thyroid cancer after surgery.Methods A total of 120 patients with thyroid cancer admitted to the First People's Hospital of Zunyi City from August 2021 to August 2022 were selected as the study objects and divided into routine group and load group by random number table method,with 60 cases in each group.Both groups were treated with radioactive^(131)I after total or near-total thyroidectomy.The conventional group was treated with 2.0μg/kg levothyroxine sodium tablets,and the load group was treated with 2.5μg/kg levothyroxine sodium tablets.Serum thyroid hormone[free triiodothyroxine(FT_(3)),free thyroxine(FT_4),thyroid stimulating hormone(TSH),thyroid peroxidase(TPO)],immune function[CD3^(+),CD4^(+),CD4^(+)/CD8^(+)]before and after treatment,occurrence of adverse reactions and prognosis were compared between the two groups.Results After treatment,FT_(3)and FT_4 levels were increased,TSH and TPO levels were decreased,and the change range of load group was greater than that of conventional group,the difference was statistically significant(P<0.05).The levels of CD3^(+),CD4^(+),CD4^(+)/CD8^(+)in load group were higher than those in conventional group after treatment(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).There was no significant difference in recurrence rate,metastasis rate and mortality between the two groups(P>0.05).Conclusion 2.5μg/kg Levothyroxine sodium tablets combined with radioactive^(131)I in the treatment of thyroid cancer patients after surgery have better effects on thyroid hormone levels,higher immune function,better prognosis,and certain safety.