TSH抑制疗法对分化型甲状腺癌术后患者免疫功能及骨代谢的影响  

Effects of TSH inhibition therapy on immune function and bone metabolism after operation in patients with differentiation thyroid cancer

作　　者：梅艳[1] 王乔 赵力威[1] 武鸿文[1] 徐蓉生[1] MEI Yan;WANG Qiao;ZHAO Liwei;WU Hongwen;XU Rongsheng(Department of Nuclear Medicine,Sichuan Provincial Tumor Hospital,Chengdu,Sichuan 610000,China)

机构地区：[1]四川省肿瘤医院核医学科,成都610000

出　　处：《重庆医学》2021年第8期1381-1384,共4页Chongqing medicine

摘　　要：目的探讨促甲状腺激素(TSH)抑制疗法对甲状腺癌术后患者甲状腺激素水平、免疫功能及骨代谢的影响。方法选择2018年1月至2019年1月该院收治的86例甲状腺癌患者作为研究对象,分为观察组43例和对照组43例。所有患者均在完成手术及放射性131I清除剩余甲状腺组织后接受药物TSH抑制治疗,观察组口服左甲状腺素钠片2.5μg/kg,对照组口服左甲状腺素钠片2.0μg/kg。比较不同抑制水平下两组患者的游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、TSH、T细胞亚群(CD3^(+)、CD4^(+)、CD8^(+))、钙(Ca)、磷(P)、碱性磷酸酶(ALP)及骨密度水平。结果治疗前,两组的FT3、FT4、TSH水平差异均无统计学意义(P>0.05);治疗后,两组的FT3、FT4水平均升高,TSH水平均降低,且观察组的变化幅度大于对照组,差异均有统计学意义(P<0.05)。治疗前,两组的CD3^(+)、CD4^(+)、CD8^(+)水平差异均无统计学意义(P>0.05);治疗后,两组的CD3^(+)、CD4^(+)水平均升高,CD8^(+)水平均降低,且观察组的变化幅度大于对照组,差异均有统计学意义(P<0.05)。治疗前,两组的Ca、P、ALP、骨密度水平差异均无统计学意义(P>0.05);治疗后,两组的Ca、P、ALP、骨密度均无显著变化(P>0.05)。结论TSH低水平抑制疗法能够明显提高甲状腺癌术后患者的FT3、FT4水平,低水平TSH有利于抑制复发和转移,积极改善患者的免疫功能,短时间内对骨代谢及骨密度无显著影响。Objective To explore the effect of TSH inhibition therapy on the thyroid hormones levels,immune function and bone metabolism after operation in the patients with thyroid cancer.Methods Eighty-six patients with thyroid cancer in this hospital from January 2018 to January 2019 were selected as the study subjects and randomly divided into the observation group(43 cases)and control group(43 cases).All patients received the medication TSH inhibition treatment after completing operation and radioactive 131I removing remaining thyroid tissue.The observation group orally took levothyroxine sodium tablet 2.5μg/kg and the control group orally took levothyroxine sodium tablet 2.0μg/kg.The levels of free triiodothyronine(FT3),free thyroxine(FT4),TSH,T cell subsets(CD3^(+),CD4^(+),CD8^(+)),calcium(CA),phosphorus(P),alkaline phosphatase(ALP)and bone mineral density under different inhibiting levels were compared between the two groups.Results The levels of FT3,FT4 and TSH before treatment had no statistical differences between the two groups(P>0.05);after treatment,the levels of FT3 and FT4 in the two groups all were increased,while the TSH level was decreased,moreover the change range of the observation group was larger than that of the control group,and the difference was statistically significant(P<0.05).Before treatment,the levels of CD3^(+),CD4^(+)and CD8^(+)had no statistical differences between the two groups(P>0.05);after treatment,thelevels of CD3^(+)and CD4^(+)in the two groups were increased,while the CD8^(+)level was decreased,moreover the change range in the observation group was larger than that in the control group,and the difference was statistically significant(P<0.05).Before treatment,the levels of Ca,P,ALP and BMD had no statistical difference between the two groups(P>0.05);after treatment,Ca,P,ALP and BMD in the two groups had no significant change(P>0.05).Conclusion The TSH low level inhibition therapy can significantly increase the levels of FT3 and FT4 after operation in the patients with thyroid cance

关 键 词：甲状腺肿瘤 促甲状腺激素 抑制治疗 免疫功能 骨代谢 骨密度 

分 类 号：R736.1[医药卫生—肿瘤]