血清t-PINP/β-CTX比值、25(OH)D水平在老年女性分化型甲状腺癌术后防治骨质疏松中的监测价值  

Value of monitoring serum t-PINP/β-CTX ratio and 25(OH)D levels in the prevention and treatment of osteoporosis after surgery for differentiated thyroid cancer in elderly women

作　　者：王冠华 吴林峰 张益明 徐鼎钧 叶小雨 戴寿旺 Wang Guanhua;Wu Linfeng;Zhang Yiming;Xu Dingjun;Ye Xiaoyu;Dai Shouwang(Department of Endocrinology,Wenzhou Integrated Traditional Chinese and Western Medicine Hospital,Wenzhou 325000,China)

机构地区：[1]温州市中西医结合医院脊柱外科,温州325000

出　　处：《中华内分泌外科杂志》2023年第2期204-208,共5页Chinese Journal of Endocrine Surgery

基　　金：温州市科技计划项目(Y20170413)。

摘　　要：目的探究老年女性分化型甲状腺癌(differentiated thyroid cancer,DTC)术后血清总I型前胶原氨基端肽(total n-terminal propeptide of typeⅠprecollagen,t-PINP)/Ⅰ型胶原羧基端肽β特殊序列(beta C-terminal cross-linked telopeptides of typeⅠcollagen,β-CTX)比值、25羟维生素D[25-hydroxy vitamin D,25(OH)D]水平变化及在防治骨质疏松症中的价值,进一步为骨质疏松症防治提供监测依据。方法收集2020年1月至2021年5月温州市中西医结合医院甲乳外科进行促甲状腺激素(thyroid stimulating hormone,TSH)抑制治疗的老年女性DTC术后患者112例进行研究,统计治疗1年后骨质疏松症发生率,根据骨质疏松症发生情况,将其分为发生组(n=78)与未发生组(n=34),比较两组患者一般资料、治疗前后甲状腺指标[TSH、游离三碘甲状腺原氨酸(free triiodothyronine,FT3)、游离甲状腺素(free thyroxine,FT4)]、骨密度、血清t-PINP/β-CTX比值、25(OH)D水平。采用SPSS 22.0软件,计数资料以例数描述,采用χ^(2)检验;等级资料以u表示,采用Ridit检验;计量资料以平均数±标准差(±s)描述,采用t检验;采用Pearson相关系数模型分析术后甲状腺指标与血清t-PINP/β-CTX比值、25(OH)D水平的相关性;通过交互作用分析治疗1年后血清t-PINP/β-CTX比值、25(OH)D水平在骨质疏松症发生中的作用。结果本研究112例老年女性DTC术后患者TSH抑制治疗1年后骨质疏松症发生率为69.64%(78/112);发生骨质疏松症患者治疗1年后血清TSH水平(0.63±0.19)mIU/ml低于未发生骨质疏松症患者(0.81±0.22)mIU/ml,血清FT3(6.15±1.71)pmol/ml、FT4水平(24.63±4.28)pmol/ml高于未发生骨质疏松症患者(4.32±1.29)pmol/ml、(20.36±3.70)pmol/ml(t1=4.391,t2=5.581,t3=5.050,均P<0.05);发生骨质疏松症患者治疗1年后血清t-PINP/β-CTX比值(130.27±18.09)、25(OH)D水平(20.18±4.15)ng/ml低于未发生骨质疏松症患者(148.56±20.37)、(23.36±4.36)ng/ml(t1=4.733,t2=3.672,均P<0.05);发生骨质疏�Objective To investigate the level change of serum total n-terminal propeptide of typeⅠprecollagen(t-PINP)/typeⅠcollagen carboxy-terminal peptide(beta-CTX)ratio,25-hydroxyvitamin D(25-hydroxyvitamin D,25(OH))ratio,and 25-hydroxyvitamin D in elderly women with differentiated thyroid cancer(DTC)after surgery and its value in the prevention and treatment of osteoporosis(OP).Methods From Jan.2020 to May.2021,112 elderly female postoperative DTC patients treated with thyroid stimulating hormone(TSH)suppression in Department of Endocrinology of Wenzhou Hospital of Integrative Medicine were collected for a prospective study,and the incidence of OP after 1 year of treatment was counted,and according to the incidence of OP,they were divided into incidence group(n=78)and non-incidence group(n=34).The general information,thyroid parameters[TSH,free triiodothyronine(FT3),free thyroxine(FT4)],bone mineral density(BMD),and serum t-titrosine(BMD)were compared between the two groups.SPSS22.0 software was used,and the counting data was described by examplesχ^(2) test.Grade data was expressed in u,Ridit test was used,measurement data was described in mean±standard deviation(±s),t test was used,Pearson correlation coefficient model was used to analyze postoperative thyroid index and serum t-PINP/β-Correlation between CTX ratio and 25(OH)D level,and serum t-PINP after 1 year of treatment was analyzed through interaction/β-The role of CTX ratio and 25(OH)D level in OP occurrence.Results The incidence of OP after 1 year of TSH suppression treatment in 112 elderly female post-DTC patients in this study was 69.64%(78/112);serum TSH levels(0.63±0.19)mIU/ml after 1 year of treatment in patients who developed OP were lower than those in patients who did not develop OP(0.81±0.22)mIU/ml,and serum FT3(6.15±1.71)pmol/ml and FT4 levels(24.63±4.28)pmol/ml were higher than those of patients without OP(4.32±1.29)pmol/ml and(20.36±3.70)pmol/ml(t1=4.391,t2=5.581,t3=5.050,all P<0.05).Serum t-PINP/β-CTX ratio(130.27±18.09)and 25(OH)D

关 键 词：老年女性 分化型甲状腺癌 骨质疏松 总I型前胶原氨基端肽 Ⅰ型胶原羧基端肽β特殊序列 25羟维生素D 

分 类 号：R736.1[医药卫生—肿瘤] R580[医药卫生—临床医学]