131I联合重组人促甲状腺激素在分化型甲状腺癌中的应用  

Application of 131I combined with recombinant human thyroid stimulating hormone in patients with differentiated thyroid carcinoma

作　　者：焦奋哲 Jiao Fenzhe(Nuclear Medicine Department,Yuncheng Central Hospital,Yuneheng 044000,China)

机构地区：[1]山西省运城市中心医院核医学科,044000

出　　处：《中国实用医刊》2018年第14期59-61,65,共4页Chinese Journal of Practical Medicine

摘　　要：目的 研究131I联合重组人促甲状腺激素（ rhTSH）在分化型甲状腺癌（ DTC）患者中的应用效果.方法 选取医院2015年1月至2017年6月DTC患者60例,按治疗方案分为观察组与对照组,每组30例.对照组采用甲状腺激素撤退疗法介导131I清甲治疗,观察组采用rhTSH介导131I清甲治疗.比较两组清甲疗效、不同检测时间血清促甲状腺激素（TSH）、游离三碘甲腺原氨酸（FT3）、游离甲状腺素（FT4）及甲状腺免疫球蛋白（Tg）水平、131I半排期与摄取率、不良反应发生情况.结果 观察组清甲总有效率（76.67%）高于对照组（50.00%）,差异有统计学意义（P＜0.05）;观察组注射后1 d血清TSH、FT3、FT4及Tg水平高于对照组,且血清FT3、FT4水平仍处于正常水平,差异有统计学意义（P＜0.05）;观察组与对照组131I摄取率[（48.67 ±5.78）%比（46.86 ±10.08）%]比较,差异未见统计学意义（P＞0.05）;观察组131I半排期低于对照组,差异有统计学意义（P＜0.05）;观察组不良反应发生率（10.00%）低于对照组（36.67%）,差异有统计学意义（P＜0.05）.结论 对DTC患者行131I与rhTSH治疗清甲疗效显著,可在短时间内提高血清TSH、Tg水平,有助于清除病灶及检测肿瘤残存、复发与转移,且对甲状腺功能无明显影响,安全性高.Objective To study the effect of 131I combined with recombinant human thyroid stim-ulating hormone （ rhTSH） on differentiated thyroid cancer （ DTC） patients.Methods From January 2015 to June 2017, 60 patients with DTC in the hospital were divided into observation group and control group according to different treatment plan , with 30 cases in each group.The control group was treated with the thyroid hormone withdrawal therapy mediated 131 I therapy for thyroid remnant ablation , and the observation group was treated with rhTSH mediated 131I therapy for thyroid remnant ablation.The thyroid remnant ablation effect , levels of serum TSH, FT3, FT4and Tg detected in different time points , the elimination half-time and uptake rate of 131 I, and the adverse reactions were observed in two groups. Results The total effective rate （76.67%） in the observation group was higher than that in the control group （50.00%）, and the difference was significant （ P〈0.05）.The level of serum TSH, FT3, FT4 and Tg of 1 d after injection in the observation group were higher than those in the control group , and the serum levels of FT3and FT4were still at the normal level, the differences were significant （P〈0.05）. There were no significant differences in the uptake rate of 131I between the observation group and the con-trol group [（48.67 ±5.78）%vs.（46.86 ±10.08）%],P〉0.05.The half-scheduling period of 131I in the observation group was lower than that in the control group , and the difference was significant （ P〈0.05 ）.The incidence of adverse reactions （10.00%） in the observation group was lower than that in the control group （36.67%） , and the difference was significant （ P〈0.05）.Conclusions The thyroid remnant ablation effect of 131I combined with rhTSH on DTC patients is significant , which can improve the levels of serum TSH and Tg in a short time , help to remove lesions and detect the tumor remnant , recur-rence and metastasis.And it has no effect on thyroid function.Besides

关 键 词：131I 重组人促甲状腺激素 分化型甲状腺癌 应用效果 

分 类 号：R736.1[医药卫生—肿瘤]