促甲状腺激素抑制疗法在甲状腺全切术后中的应用效果分析  

Effect of Thyroid Hormone Suppression Therapy after Total Thyroidectomy

作　　者：张锐江[1] 关阳铭 ZHANG Ruijiang;GUAN Yangming(Zhongshan Chenxinghai Hospital,Zhongshan 528400,China;不详)

机构地区：[1]中山市陈星海医院,广东中山528400

出　　处：《中外医学研究》2022年第28期111-115,共5页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探讨促甲状腺激素(TSH)抑制疗法在甲状腺全切术后的应用效果。方法:选取2019年1月-2021年1月中山市陈星海医院收治的分化型甲状腺癌患者102例,使用随机数字表法将其分为观察组(n=51)及对照组(n=51)。两组均进行甲状腺全切术,对照组接受促甲状腺激素替代疗法,观察组接受TSH抑制疗法,对比两组的甲状腺激素水平、疾病血清相关指标、肿瘤相关因子及预后情况。结果:治疗前,两组的游离三碘甲状腺原氨酸(FT)、游离甲状腺素(FT)及促甲状腺激素(TSH)水平相比差异无统计学意义(P>0.05)。治疗后,两组的FT、FT升高,TSH降低,观察组均优于对照组,差异有统计学意义(P<0.05)。治疗前,两组的甲状腺球蛋白(Tg)、血管内皮生长因子(VEGF)、肿瘤特异性生长因子(TSGF)、白细胞分化抗原44变异型6(CD44V6)、可溶性白细胞介素-2受体(sIL-2R)水平比较差异无统计学意义(P>0.05)。治疗后,两组的各项指标均降低,观察组低于对照组,差异均有统计学意义(P<0.05)。治疗前,两组的肿瘤坏死因子诱导蛋白8样蛋白2(TIPE2)及信号转导子和转录激活因子3(STAT3)的阳性表达率比较差异无统计学意义(P>0.05)。治疗后,两组的TIPE2阳性表达率升高,STAT3阳性表达率降低,观察组均优于对照组,差异有统计学意义(P<0.05)。治疗后12个月观察组的复发率(1.96%)及转移率(1.96%)均低于对照组(13.73%、15.69%),差异均有统计学意义(P<0.05)。结论:TSH抑制疗法在甲状腺全切术后应用效果显著,可维持正常的甲状腺功能,可有效抑制切除癌组织周围组织中STAT3的阳性表达,提高TIPE2的阳性表达,降低血清Tg、VEGF、TSGF、CD44V6、sIL-2R水平,抑制复发及转移。Objective:To investigate the effect of thyroid stimulating hormone (TSH) suppression therapy after total thyroidectomy.Method:One hundred and two patients with differentiated thyroid cancer admitted to Zhongshan Chenxinghai Hospital from January 2019 to January 2021 were selected and divided into observation group (n=51) and control group (n=51) by the random number table method.Total thyroidectomy was performed in both group.The control group received thyroid hormone replacement therapy and the observation group received TSH suppression therapy.The thyroid hormone levels,disease serum-related indexes,tumor-related factors and prognosis of the two groups were compared.Result:Before treatment,there were no significant differences in the levels of free triiodothyronine (FT),free thyroxine (FT) and thyroid stimulating hormone (TSH) between the two groups (P>0.05).After treatment,FTand FTincreased and TSH decreased in both groups,and the observation group were better than the control group,the differences were statistically significant (P<0.05).Before treatment,the levels of thyroglobulin (Tg),vascular endothelial growth factor (VEGF),tumor-specific growth factor (TSGF),leukocyte differentiation antigen 44 variant 6 (CD44V6),and soluble interleukin-2 receptor (sIL-2R) were not significantly different between the two groups (P>0.05).After treatment,the above indexes in both groups were reduced,and the indexes in the observation group were lower than the control group,the differences were statistically significant (P<0.05).Before treatment,there were no significant differences in the positive expression rates of tumor necrosis factor-inducible protein 8-like protein 2 (TIPE2) and signal transducer and activator of transcription 3 (STAT3) between the two groups (P>0.05).After treatment,the positive expression rate of TIPE2 increased and the positive expression rate of STAT3 decreased in both groups,and the indexes in the observation group were better than the control group,the differences were statistically significant

关 键 词：促甲状腺激素抑制疗法 分化型甲状腺癌 甲状腺全切术 

分 类 号：R736.1[医药卫生—肿瘤]