左甲状腺素片在老年甲状腺癌根治术后应用的价值  

The value of levothyroxine tablet in the treatment of thyroid cancer

作　　者：田明明 陈志峰 章幂 Tian Mingming;Chen Zhifeng;Zhang Mi(Department of General Surgery,Suqian Branch of Jiangsu Provincial People's Hospital,Suqian 223800,China)

机构地区：[1]江苏省人民医院宿迁分院甲乳外科,江苏宿迁223800

出　　处：《国际免疫学杂志》2021年第2期158-165,共8页International Journal of Immunology

摘　　要：目的探讨左甲状腺素片在甲状腺癌根治术后应用的价值。方法选取2015年12月至2019年1月江苏省人民医院宿迁分院甲状腺癌患者92例,随机数字表法进行分组,每组46例。两组患者均采取甲状腺癌改良根治术,术后研究组加用左旋甲状腺素片辅助治疗。统计两组临床疗效、治疗前及治疗一个月后甲状腺功能指标、免疫功能指标、p27蛋白阳性表达情况、血清肿瘤特异性生长因子(tumor specific growth fanctor,TSGF)、白细胞分化抗原44变异型6(cluster of differentiation variant 6,CD44V6)、可溶性白细胞介素-2受体(soluble interleukin receptor-2,sIL-2R)水平。结果①研究组总有效率高于对照组[(95.65%,44/46)比(82.61%,38/46),χ^(2)=4.039,P=0.045];②治疗一个月后两组促甲状腺素(thyroid stimulating hormone,TSH)水平较治疗前降低、甲状腺素(thyroxin,T_(4))、三碘甲状腺原氨酸(triiodothyronine,T_(3))、游离甲状腺素(free thyroxine,FT_(4))、游离三碘甲状腺原氨酸(free triiodothyronine,FT_(3))水平较治疗前增高(研究组:t值分别为24.461、13.553、12.898、16.422、11.558;对照组:t值分别为21.189、7.562、10.979、11.965、8.442,P值均<0.05),且研究组TSH水平低于对照组,T_(4)、T_(3)、FT_(4)、FT_(3)水平高于对照组(t值分别为6.511、5.456、3.951、6.969、4.722,P值均<0.05);③治疗一个月后两组CD3^(+)、CD4^(+)水平较治疗前增高、CD8^(+)水平较治疗前降低(研究组:t值分别为5.762、14.394、15.449,对照组:t值分别为2.367、8.375、9.183,P值均<0.05),且研究组CD3^(+)、CD4^(+)水平高于对照组,CD8^(+)水平低于对照组(t值分别为3.486、7.448、6.496,P值均<0.05);④治疗一个月后两组p27蛋白阳性表达率较治疗前增高,且研究组明显高于对照组[(80.43%,37/46)比(58.70%,27/46),χ^(2)=5.134,P<0.05];⑤治疗一个月后两组血清TSGF、CD44V6、sIL-2R水平较治疗前降低(研究组:t值分别为9.137、32.272、27.270;对照组:t值分别为3.961Objective To explore the value of levothyroxine tablets in the treatment of thyroid cancer.Method A total of 92 patients with thyroid cancer in Suqian Branch of Jiangsu Provincial People's Hospital from December 2015 to January 2019 were selected and divided into the study group and the control group by the random number table method,46 in each group.Both groups were treated with modified radical thyroid cancer surgery,and levothyroxine tablets were added to the study group after surgery.The clinical efficacy,thyroid function indexes,immune function indexes,positive expression of p27 protein,serum tumor specific growth fanctor(TSGF),leukocyte differentiation antigen 44 variant 6(CD44V6),and the soluble interleukin receptor-2(sIL-2R)levels were counted in both groups before and after one month of treatment.Results①The overall effective rate was higher in the study group than that in the control group[(95.65%,44/46)vs(82.61%,38/46);χ^(2)=4.039,P=0.045];②After one month of treatment,the levels of thyroid stimulating hormone(THH),decreased in both groups compared with those before treatment.thyroxin(T_(4)),triiodothyronine(T_(3)),free thyroxine(FT_(4)),and free triiodothyronine(FT_(3))levels were higher in both groups after one month of treatment(study group:t values were 24.461,13.553,12.898,16.422 and 11.558 respectively,control group:t values were 21.189,7.562,10.979,11.965 and 8.442 respectivelly;all P values<0.05).TSH levels in the study group were lower than those in the control group,and T_(4),T_(3),FT_(4),FT_(3) levels were higher than those in the control group(t values were 6.511,5.456,3.951,6.969 and 4.722 respectively;all P values<0.05);③after one month of treatment,CD3^(+)and CD4^(+)levels were higher,and CD8^(+)levels were lower in both groups than before treatment(study group:t values were 5.762,14.394 and 15.449 respectively;control group:t values were 2.367,8.375,9.183 respectively;all P values<0.05).CD3^(+)and CD4^(+)levels were higher in the study group than in the control group,and CD8^(+)l

关 键 词：左旋甲状腺素片 改良根治术 甲状腺癌 甲状腺功能 免疫功能 P27蛋白 

分 类 号：R736.1[医药卫生—肿瘤]