^(131)I治疗前后甲状腺素变化对分化型甲状腺癌患者脂蛋白α的影响研究  

Effects of Thyroxine Changes Before and After Iodine-131 Treatment on Lipoproteinαin Patients with Differentiated Thyroid Cancer

作　　者：陈泽泉[1] 杨佳欢 余永利[1] 柴红[1] CHEN Zequan;YANG Jiahuan;YU Yongli;CHAI Hong(Department of Nuclear Medicine, Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University, Shanghai 201306, China)

机构地区：[1]上海交通大学附属第六人民医院核医学科,上海201306

出　　处：《标记免疫分析与临床》2021年第4期583-586,共4页Labeled Immunoassays and Clinical Medicine

摘　　要：目的研究131I治疗前后分化型甲状腺癌患者脂蛋白α(Lp-α)代谢的影响,及甲状腺素、血脂指标与脂蛋白α间的关系。方法选取2015年至2018年在我院接受131I治疗分化型甲状腺癌患者128例(男性45例,女性83例),测定患者停药前及甲状腺素撤出及替代抑制治疗后Lp-α及各项血脂指标、血清游离甲状腺素(FT4)、游离三碘甲酰原氨酸(FT3)、促甲状腺素(TSH),分析甲状腺素变化对患者血清三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、脂蛋白α(Lp-α)影响,分析甲状腺素、血脂指标与Lp-α间关系。结果随着甲状腺素撤出后,患者Lp-α、TG、TCHO、HDL-C、LDL-C、TSH均明显增高,FT3、FT4下降,P均<0.01。Lp-α与LDL-C呈正相关;TC与TG、HDL-C、LDL-C、TSH呈正相关;与FT3、FT4呈负相关。HDL-C与TSH、LDL-C呈正相关;与FT3、FT4呈负相关;LDL-C与FT3、FT4呈负相关,与TSH、Lp-α呈正相关;甲状腺素替代治疗4周后,患者甲状腺相关指标及血脂指标恢复至停药前水平,两者比较差异无统计学意义。结论131I治疗前后甲状腺素的变化可引起Lp-α水平变化;该变化与甲状腺指标无明显关系,与LDL-C呈正相关,经替代抑制治疗后,各项指标均可恢复至停药前水平。Objective To study the effect of iodine-131 on lipoproteinα(LP-α)metabolism in patients with differentiated thyroid cancer and the relationship between thyroid hormone,blood lipid and lipoproteinα.Methods 128 patients(45 males and 83 females)with differentiated thyroid cancer who received 131 iodine treatment in our hospital from 2015 to 2018 were selected for the current study.LP-αand various blood lipid indexes,serum free thyroxine(FT4),free triiodothyronine(FT3)and thyrotropin(TSH)were measured before drug withdrawal and after thyroxine withdrawal and replacement inhibition treatment.The changes of thyroxine and how serum triglyceride(TG),total cholesterol(TC),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C)and lipoprotein alpha(LP-α)of patients were affected by these changes were analyzed.The relationship between thyroxine,blood lipid and LP-αwas also analyzed.Results With the withdrawal of thyroxine,LP-α,TG,TCHO,HDL-C,LDL-C,and TSH were significantly increased,while FT3 and FT4 were decreased(P<0.01).LP-αwas positively correlated with LDL-C,and TC was positively correlated with TG,HDL-C,LDL-C and TSH,while negatively correlated with FT3 and FT4.HDL-C was positively correlated with TSH and LDL-C,while negatively correlated with FT3 and FT4.LDL-C was negatively correlated with FT3 and FT4,while positively correlated with TSH and LP-α.After 4 weeks of thyroxine replacement therapy,thyroid related indexes and blood lipid indexes returned to the level as before drug withdrawal,and there was no significant difference between the two.Conclusion The change of thyroxine before and after iodine-131 treatment can cause the change of LP-αconcentration,which has no significant relationship with thyroid indexes,but is positively correlated with LDL-C.after the replacement inhibition treatment.All indexes can return to the level as before drug withdrawal.

关 键 词：分化型甲状腺癌 甲状腺素撤出 脂代谢紊乱 脂蛋白Α 

分 类 号：R736.1[医药卫生—肿瘤]