分化型甲状腺癌术后促甲状腺激素抑制治疗对体内性激素水平影响  

Effect of thyroid stimulating hormone therapy on sex hormone levels in patients with differentiated thyroid carcinoma after operation

作　　者：郑育强 丁锦辉[1] 高蕾 李小雷 宋磊[1] ZHENG Yuqiang;DING Jinhui;GAO Lei;LI Xiaolei;SONG Lei(Department of General Surgery,Central Hospital of Xinjiang Karamay,Karamay,Xinjiang 834409,China)

机构地区：[1]克拉玛依市中心医院普外科,新疆克拉玛依市834409

出　　处：《新疆医学》2020年第9期941-945,共5页Xinjiang Medical Journal

摘　　要：目的探讨分化型甲状腺癌术后促甲状腺激素(TSH)抑制治疗对性激素、女性月经及绝经年龄影响。方法收集2011年1月-2017年1月期间在本院行手术治疗,术后行TSH抑制治疗的分化型甲状腺癌患者,将患者分为TSH<0.1 IU/L、0.1 IU/L≤TSH<0.5 IU/L和TSH≥0.5 IU/L三组,对三组患者相关数据进行比较,分析不同TSH抑制治疗时间及抑制程度对患者的影响。结果在男性患者中,雌二醇(E2)和睾丸酮(T)在不同用药时间及抑制状态下均未产生明显变化,差异无统计学意义(P>0.05)。女性患者中,T水平测定在TSH抑制治疗3~5年、TSH≥0.5 IU/L组表现最低,与其他组比较差异有统计学意义(P<0.05),绝经期女性患者中E2、卵泡刺激素(FSH)水平在各组中比较差异无统计学意义(P>0.05),性成熟期女性中,E2在0.1 IU/L≤TSH<0.5 IU/L,用药时间5年内组水平最低,差异具有统计学意义(P<0.05),FSH未受到明显影响,差异无统计学意义(P>0.05),在各组女性经期症状及绝经时间比较,差异无统计学意义(P>0.05)。结论男性患者TSH抑制治疗未对性激素产生影响,治疗相对安全,女性患者性激素指标在TSH抑制后发生变化,但经期症状及绝经年龄无明显影响。Objective To investigate the effects of thyroid stimulating hormone(TSH)inhibition therapy on sex hormones,female menstruation and menopausal age in patients with differentiated thyroid cancer after surgery.Methods From January 2011 to January2017,patients with differentiated thyroid cancer who received surgical treatment and postoperative TSH suppression therapy were collected and divided into three groups:TSH<0.1 IU/L,0.1 IU/L≤TSH<0.5 IU/L and TSH≥0.5 IU/L.The relevant data of the three groups were compared,and the effects of different TSH suppression treatment time and inhibition degree on patients were analyzed.Results In male patients,estradiol(E2)and testosterone(T)did not change significantly in different medication time and inhibition state,the difference was not statistically significant(P>0.05).Among the female patients,the T level was the lowest in the TSH suppression treatment group with TSH≥0.5 IU/L for 3-5 years,and the difference was statistically significant(P<0.05).There was no significant difference in the levels of E2 and follicle stimulating hormone(FSH)among the menopausal women(P>0.05).Among the sexually mature women,the E2 level was 0.1 IU/L≤TSH<0.5 IU/L,and the lowest level was found within 5 years,The difference was statistically significant(P<0.05),FSH was not significantly affected,the difference was not statistically significant(P>0.05).Conclusions Male patients with TSH suppression treatment has no effect on sex hormones,and the treatment is relatively safe.The sex hormone indexes of female patients change after TSH suppression,but the menstrual symptoms and menopausal age have no significant influence.

关 键 词：甲状腺癌 促甲状腺激素 性激素 月经 

分 类 号：R736[医药卫生—肿瘤]