盐酸安罗替尼治疗晚期恶性肿瘤甲状腺激素的变化及干预治疗  

Changes of Thyroid Hormone in Patients with Advanced Malignant Tumor Treated by Anlotinib Hydrochloride and Its Intervention

作　　者：梁洪享[1] 黄燕[1] 刘合代[1] 黄骞[1] 袁翠堂[1] 徐菊娣[1] 杨志勇 李书芹 LIANG Hongxiang;HUANG Yan;LIU Hedai;HUANG Qian;YUAN Cuitang;XU Judi;YANG Zhiyong;LI Shuqin(Department of Oncology,Chongming Branch of Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai,202150,China;Department of Hematology,Chongming Branch of Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai,202150,China)

机构地区：[1]上海交通大学医学院附属新华医院崇明分院肿瘤科,上海202150 [2]上海交通大学医学院附属新华医院崇明分院血液科,上海202150

出　　处：《肿瘤药学》2021年第1期113-115,125,共4页Anti-Tumor Pharmacy

基　　金：上海市卫生健康委员会科研课题计划书(201940274);上海市崇明区科学技术委员会项目资助(CKY2019-18)。

摘　　要：目的探讨盐酸安罗替尼对晚期恶性肿瘤患者甲状腺激素水平的影响。方法用免疫化学发光法检测81例晚期恶性肿瘤患者盐酸安罗替尼治疗前后的甲状腺激素(TH)水平。针对盐酸安罗替尼治疗后TH下降的患者使用左甲状腺素钠片治疗,并观察其疗效。结果晚期肿瘤患者安罗替尼治疗后,53例(65.43%)出现TH异常[三碘甲状腺原氨酸(T3)或四碘甲状腺原氨酸(T4)下降或促甲状腺素(TSH)升高],其中33例(40.74%)治疗前TH异常,20例(24.69%)治疗前TH正常,治疗后出现异常;对盐酸安罗替尼治疗后甲状腺指标下降的患者予补充左甲状腺素钠片干预治疗后,T3、T4、游离三碘甲状腺原氨酸(FT3)、游离四碘甲状腺原氨酸(FT4)变化不明显(P>0.05),而TSH明显下降(P<0.05)。结论盐酸安罗替尼治疗晚期肿瘤可能引起患者甲状腺功能低下,而单纯补充左甲状腺素钠片治疗无明显疗效。Objective To investigate the adverse effects of anlotinib hydrochloride on thyroid hormone(TH)level of patients with advanced cancer.Methods The levels of thyroid hormone in 81 patients with advanced malignant tumor before and after treatment with anlotinib hydrochloride were measured by immunochemiluminescence assay.The patients with hypothyroidism were treated with levothyroxine sodium tablets and the effects were observed.Results After treatment with anlotinib hydrochloride,53 patients(65.43%)had abnormal TH,including decreased triiodothyronine(T3)or tetraiodothyronine(T4)level,or increased thyroid stimulating hormone(TSH)level.Among the 53 patients,33(40.74%)of them had abnormal TH before treatment,and 20(24.69%)had normal TH before treatment but abnormal TH after treatment.After the intervention with levothyroxine sodium tablets,no apparent changes were observed in the levels of T3,T4,free triiodothyronine(FT3)and free tetraiodothyronine(FT4)(P>0.05),but the TSH level was significantly decreased(P<0.05).Conclusion In the treatment of advanced tumor,anlotinib hydrochloride may cause hypothyroidism,while levothyroxine alone has no significant curative effect.

关 键 词：盐酸安罗替尼 甲状腺激素 恶性肿瘤 

分 类 号：R730.6[医药卫生—肿瘤]