桥本氏病合并分化型甲状腺癌治疗前后甲状腺功能的变化趋势及其影响因素  

Changes in Thyroid Function and Its Influencing Factors After the Treatment of Hashimoto's Disease with Differentiated Thyroid Carcinoma

作　　者：乐忠宏[1] LE Zhonghong(Jiaozuo People's Hospital,Jiaozuo,454002)

机构地区：[1]河南省焦作市人民医院,454002

出　　处：《实用癌症杂志》2022年第7期1202-1204,共3页The Practical Journal of Cancer

基　　金：河南省医学科技攻关计划联合共建项目(编号:LHGJ20191336)。

摘　　要：目的分析桥本氏病合并分化型甲状腺癌治疗前后甲状腺功能的变化趋势及其影响因素。方法选取102例桥本氏病合并分化型甲状腺癌患者,依照患者实际接受的治疗方案分为A、B组,A组(35例):TgAb检测时间点为手术前及手术后(患者主动要求不继续接受后续^(131)I治疗);B组(67例):TgAb检测时间点为手术前、手术后以及术后^(131)I治疗2.5个月时、5个月时(患者手术后继续接受后续^(131)I治疗)。采用电化学发光免疫分析法检测体内TgAb水平;分析影响体内TgAb的因素。结果A组患者TgAb水平治疗前后3个时间点呈现逐渐减低趋势(P<0.05),但治疗后5个月随访水平为(221.78±12.08)U/ml;手术后继续接受^(131)I治疗的B组患者TgAb水平持续降低,5个月随访水平为(150.31±9.73)U/ml。手术前、手术后A、B组患者TgAb水平差别未见统计学意义;随访5个月则可见B组患者TgAb水平显著低于A组(P<0.05),且TgAb水平与^(131)I治疗距手术的间隔时间呈显著相关关系(P<0.05),与年龄、性别、^(131)I治疗剂量无显著相关关系(P>0.05)。结论手术及^(131)I治疗可有效降低桥本氏病合并分化型甲状腺癌患者体内TgAb水平,且手术与^(131)I治疗的间隔时间越短越有利于降低体内TgAb水平。Objective To analyze the change trend of thyroid function and its influencing factors after the treatment of Hashimoto's disease with differentiated thyroid carcinoma.Methods 102 patients with Hashimoto's disease combined with differentiated thyroid cancer were selected and divided into groups A and B according to the actual treatment plan received by the patients.Group A(35 cases):TgAb detection time points were before and after surgery(patients actively Request not to continue to receive follow-up^(131)I treatment);group B(67 cases):TgAb detection time points were before surgery,after surgery,and at 2.5 months and 5 months of postoperative^(131)I treatment(patients continued to receive follow-up^(131)I treatment after surgery);Using electrochemiluminescence immunoassay to measure the level of TgAb in vivo;to analyze the influencing factors of TgAb in vivo.Results The TgAb level of group A patients in this study showed a decreasing trend at three time points before and after treatment(P<0.05),but the follow-up level was(221.78±12.08)U/ml 5 months after treatment;those who continued to receive^(131)I treatment after surgery The TgAb level of patients in group B continued to decrease,and the 5-month follow-up level was(150.31±9.73)U/ml;there was no significant difference in TgAb levels in group AB patients before and after surgery;after 5-month follow-up,TgAb levels in group B were found levels were significantly lower(P<0.05).Multivariate logistic regression on the basis of univariate Logistics regression showed that there was a significant correlation between^(131)I treatment and operation time(P<0.05),but no significant correlation with age,gender,and^(131)I treatment dose(P>0.05).Conclusion Surgery and^(131)I treatment can effectively reduce TgAb level in Hashimoto's disease patients with differentiated thyroid cancer.The shorter the operative time and^(131)I interval,the lower the TgAb level in vivo.

关 键 词：桥本氏病合并分化型甲状腺癌 甲状腺功能 变化趋势 影响因素 

分 类 号：R736.1[医药卫生—肿瘤]