甲状腺癌术后短期甲状腺机能减退对骨密度及脂肪分布的影响  

Effect of short-term hypothyroidism after the surgery for thyroid carcinoma on bone mineral density and fat distribution

作　　者：张金赫[1] 尹吉林[1] 邓伟民[2] 王成[1] 禹晖[1] 章明[1] 梁瑛[1] 安文峰 姜丽莎[1] 

机构地区：[1]广州军区广州总医院核医学科,广州510010 [2]广州军区广州总医院高级医疗中心,广州510010

出　　处：《中国骨质疏松杂志》2014年第7期747-749,共3页Chinese Journal of Osteoporosis

基　　金：广东省医疗科技推广专项课题(GDKX201101)

摘　　要：目的观察短期甲状腺机能减退对患者骨密度及脂肪分布的影响,探讨二者之间的相关性。方法选择甲状腺癌患者22例,均行甲状腺全切术或近全切术,术后4~8周或停用左甲状腺素后3~6周均行131I去除治疗（去除治疗后48小时即开始使用左旋甲状腺素）,对该组病例术前、131I治疗前,131I治疗后3~6个月,分别行全身骨密度测定及脂肪分布测定。结果22例甲癌患者,术前游离三碘甲状腺原氨酸（FT3）平均为（4.55±0.91）pmol/L,术后4~6周平均为（1.21±0.41）pmol/L,131I治疗后3~6个月平均为（5.70±1.17）pmol/L;三次骨密度测定,无明显变化;三次体脂含量分别为21.75±8.01 kg,23.05±7.96 kg,21.53±7.73 kg,甲减状态时,体脂含量明显增加（第二次减去第一次,P〈0.01）;甲减恢复后,体脂含量亦随之基本恢复（第三次减去第一次,P=0.36）。结论短期甲减对患者骨密度无明显影响,但可使患者体脂含量明显增高,且该改变随着甲状腺机能减退的纠正而逐渐恢复。Objective To observe the effect of short-term hypothyroidism after the surgery for hyroid carcinoma on bone mineral density （BMD） and fat distribution, and to investigate the correlation between them. Methods Twenty-two patients with thyroid cancer were selected. All these patients underwent total thyroidectomy or subtotal resection. The 131I removal treatment began at the 4th to the 8th week after the operation or at the 3rd to the 6th week after the discontinuation of levothyroxine. The application of levothyroxine started at the 48th hour after the 131I removal treatment. BMD and fat distribution of all the patients were detected before the operation, before the 131I treatment, and 3 -6 months after the treatment of 131I, respectively. Results Among all these 22 patients with thyroid cancer, the average levels of free triiodothyronine （FT3） before the operation, 4 - 6 weeks after operation, and 3 -6 months after treatment of 131I were 4.55 ± 0. 91 pmol/L, 1.21 ± 0. 41 pmol/L, and 5. 70± 1.17 pmol/L, respectively. BMD determination showed no significant changes. The body fat contents were 21.75 ± 8.01 kg, 23.05± 7.96 kg, 21.53 ± 7.73 kg, respectively. Body fat content increased significantly during hypothyroidism （the second level minus the first one, P 〈 0.01 ）. After recovering from hypothyroidism, body fat content also recovered （ the third level minus the first one, P = 0. 36）. Conclusion The short-term hypothyroidism has no effect on BMD of the patients, but can make the body fat content increase significantly. And the changes gradually recover after the correction of hypothyroidism.

关 键 词：甲状腺机能减退 骨密度 体脂含量 甲状腺癌 

分 类 号：R58[医药卫生—内分泌]