乳头状甲状腺癌术后使用负荷剂量左甲状腺素钠的临床应用效果分析  

Analysis of clinical effect of loading dose of levothyroxine sodium after surgery for papillary thyroid carcinoma

作　　者：张奕平 林素珍[1] ZHANG Yi-ping;LIN Su-zhen(Longyan Second Hospital,Longyan 364000,China)

机构地区：[1]龙岩市第二医院,364000

出　　处：《中国现代药物应用》2023年第12期118-120,共3页Chinese Journal of Modern Drug Application

摘　　要：目的分析乳头状甲状腺癌(PTC)术后使用负荷剂量左甲状腺素钠的临床应用效果。方法85例PTC术后患者,以治疗方案不同为分为观察组(42例)与对照组(43例)。观察组接受负荷剂量左甲状腺素钠治疗,对照组接受常规剂量左甲状腺素钠治疗。比较两组甲状腺功能[促甲状腺激素(TSH)、游离四碘甲状腺原氨酸(FT_(4))、游离三碘甲状腺原氨酸(FT_(3))、甲状腺过氧化物酶(TPO)]、血脂指标[总胆固醇(TC)、甘油三酯(TG)]、血糖指标[糖化血红蛋白(HbA1c)、空腹血糖(FBG)]、复发率及治疗前后生活质量核心量表(QLQ-C30)评分。结果治疗后,观察组TSH(0.28±0.09)mIU/L、TPO(20.38±3.30)IU/L低于对照组的(0.51±0.13)mIU/L、(25.75±3.27)IU/L,FT4(25.26±4.16)pmol/L、FT3(5.10±0.15)pmol/L高于对照组的(20.02±3.14)、(4.56±0.20)pmol/L,差异有统计学意义(P<0.05)。治疗后,观察组TC、TG、FBG、HbA1c分别为(3.26±0.51)mmol/L、(2.96±0.06)mmol/L、(4.31±1.07)mmol/L、(5.42±0.20)%,均低于对照组的(3.91±0.78)mmol/L、(3.11±0.08)mmol/L、(5.19±1.11)mmol/L、(5.95±0.27)%,差异有统计学意义(P<0.05)。治疗后,观察组QLQ-C30评分(82.71±6.52)分高于对照组的(70.67±5.64)分,差异有统计学意义(P<0.05)。观察组复发率2.4%低于对照组的20.9%,差异有统计学意义(P<0.05)。结论PTC术后接受负荷剂量左甲状腺素钠治疗的效果显著,可改善甲状腺功能,调节血脂、血糖代谢,减少复发,提高患者生活质量。Objective To analyze the clinical effect of loading dose of levothyroxine sodium after surgery for papillary thyroid carcinoma(PTC).Methods A total of 85 patients with PTC were divided into observation group(42 cases)and control group(43 cases)according to different treatment methods.The observation group received loading dose of levothyroxine sodium,and the control group received conventional dose of levothyroxine sodium.Both groups were compared in terms of thyroid function[thyroid stimulating hormone(TSH),free tetraiodothyronine(FT4),free triiodothyronine(FT3),thyroid peroxidase(TPO)],blood lipid indexes[total cholesterol(TC),triglyceride(TG)],blood glucose indexes[glycosylated hemoglobin(HbA1c),fasting blood glucose(FBG)],recurrence rate,and Quality of Life Questionary-Core 30(QLQ-C30)score before and after treatment.Results After treatment,TSH of(0.28±0.09)mIU/L and TPO of(20.38±3.30)IU/L in the observation group were lower than those of(0.51±0.13)mIU/L and(25.75±3.27)IU/L in the control group;FT4 of(25.26±4.16)pmol/L and FT3 of(5.10±0.15)pmol/L in the observation group were higher than those of(20.02±3.14)and(4.56±0.20)pmol/L in the control group;the differences were statistically significant(P<0.05).After treatment,TC,TG,FBG and HbA1c were(3.26±0.51)mmol/L,(2.96±0.06)mmol/L,(4.31±1.07)mmol/L and(5.42±0.20)%in the observation group,which were lower than those of(3.91±0.78)mmol/L,(3.11±0.08)mmol/L,(5.19±1.11)mmol/L and(5.95±0.27)%in the control group,and the differences were statistically significant(P<0.05).After treatment,the QLQ-C30 score of(82.71±6.52)points in the observation group was higher than that of(70.67±5.64)points in the control group,and the difference was statistically significant(P<0.05).The recurrence rate of 2.4%in the observation group was lower than that of 20.9%in the control group,and the difference was statistically significant(P<0.05).Conclusion Loading dose of levothyroxine sodium has significant effect after surgery for PTC,which can improve the thyroid function,r

关 键 词：左甲状腺素钠 乳头状甲状腺癌 负荷剂量 生活质量 血糖 血脂 

分 类 号：R736.1[医药卫生—肿瘤]