不同剂量TSH抑制疗法对围绝经期甲状腺癌术后患者骨密度及血清Tg、MIP-1α水平的影响  

Effects of different doses of TSH inhibition therapy on bone mineral density and serum Tg and MIP-1αin patients with perimenopausal thyroid cancer after operation

作　　者：林庆军[1] 杜丽[1] 林燕晖 林燕纯 陈业晞[1] Lin Qingjun;Du Li;Lin Yanhui;Lin Yanchun;Chen Yexi(Department of Nail and Breast Hernia Surgery,the Second Affiliated Hospital of Shantou University of Medical college,Shantou 515041)

机构地区：[1]汕头大学医学院第二附属医院甲乳疝外科,广东汕头515041

出　　处：《中国现代医药杂志》2024年第1期17-21,共5页Modern Medicine Journal of China

基　　金：汕头市科技计划项目(编号:220517216492128)。

摘　　要：目的探究不同剂量促甲状腺激素(Thyroid stimulating hormone,TSH)抑制疗法对围绝经期甲状腺癌术后患者骨密度及血清甲状腺球蛋白(Thyroglobulin,Tg)、巨噬细胞炎性蛋白-1α(Macrophage inflammatory protein-1 alpha,MIP-1α)水平的影响。方法回顾性选取2021年9月~2023年7月在我院接受治疗的110例围绝经期甲状腺癌术后患者为研究对象。根据不同的TSH治疗剂量将患者分为高剂量组和低剂量组,每组55例。治疗后观察评估两组治疗疗效;比较两组患者的游离三碘甲状腺原氨酸(Free triiodothyronine,FT3)、游离甲状腺素(Free thyroxine,FT4)、TSH、Tg、癌胚抗原(Carcinoembryonic antigen,CEA)、MIP-1α、钙、磷及骨密度水平。结果高剂量组临床总有效率为87.27%,显著高于低剂量组的70.91%(P<0.05);治疗后,两组TSH水平明显下降,且高剂量组显著低于低剂量组(P<0.05),FT3及FT4水平均上升,且高剂量组高于低剂量组(P<0.05);血清Tg、CEA及MIP-1α水平明显降低,且高剂量组低于低剂量组(P<0.05);治疗后钙、磷及骨密度各指标水平差异无统计学意义(P>0.05)。结论高剂量的TSH抑制疗法相比低剂量的疗效更好,能更有效地抑制患者TSH的分泌,间接降低血清Tg和MIP-1α水平,且两种疗法均对患者的骨代谢不产生明显影响。Objective To explore the effects of different doses of Thyroid Stimulating Hormone(TSH)inhibition therapy on bone mineral density and serum thyroglobulin(Tg)and Macrophage Inflammatory Protein-1 alpha(MIP-1α)in patients with perimenopausal thyroid cancer after operation.Methods A total of 110 patients with perimenopausal thyroid cancer who were treated in our hospital from Sep 2021 to Jul 2023 retrospectively selected as the study subjects.According to different TSH treatment doses,the patients were divided into high-dose group and low-dose group,with 55 patients in each group.After treatment,the curative effect of the two groups were observed and evaluated.The levels of free triiodothyronine(FT3),free thyroxine(FT4),TSH,Tg,carcinoembryonic antigen(CEA),MIP-1α,calcium,phosphorus and bone mineral density were compared between the two groups.Results The total effective rate of clinical efficacy was 87.27%significantly higher than the 70.91%in the high-dose group(P<0.05).After treatment,the level of TSH was significantly decreased,and the high-dose group was significantly lower than the low-dose group(P<0.05);The levels of FT3 and FT4 were increased,and the high-dose group was higher than the low-dose group(P<0.05);The levels of serum Tg,CEA and MIP-1αin the high-dose group were significantly lower than those in the low-dose group(P<0.05).There was no significant change in the levels of calcium,phosphours and bone mineral density after treatment(P>0.05).Conclusion High-dose TSH inhibition therapy surpasses low-dose TSH treatment in effectively suppressing TSH secretion,leading to indirect reduvtions in serum.Tg and MIP-1αlevels.Both therapies have no significant effect on patient bone metabdism.

关 键 词：TSH抑制疗法 围绝经期 甲状腺癌 骨密度 血清甲状腺球蛋白 巨噬细胞炎性蛋白-1Α 

分 类 号：R736.1[医药卫生—肿瘤]