通过血清AMH评价^(131)I治疗对分化型甲状腺癌患者卵巢贮储备功能的影响  

The Impact of Iodine-131 Internal Radiation Therapy on Ovarian Reserve in Patients with Differentiated Thyroid Cancer Evaluated by Serum AMH

作　　者：陈龙 粟宇 陈志军[1] CHEN Long;SU Yu;CHEN Zhi-jun(Department of Nuclear Medicine,Jiangxi Cancer Hospital,Nanchang 330029,China)

机构地区：[1]江西省肿瘤医院核医学科,南昌330029

出　　处：《实用临床医学（江西）》2024年第5期16-19,共4页Practical Clinical Medicine

摘　　要：目的分析接受^(131)I内照射治疗的分化型甲状腺癌的女性患者血清抗缪勒氏管激素(anti-Müllerian hormone,AMH)水平,了解^(131)I内照射治疗对患者卵巢功能的损害程度及治疗后卵巢功能的恢复情况。方法选取首次行^(131)I内照射治疗的女性分化型甲状腺癌患者共计73例,患者既往月经规律、无明显卵巢功能异常,分别于^(131)I内照射治疗前1 d及治疗后4 d、3个月和6个月检测患者血清AMH,其中14例患者^(131)I治疗前AMH值低于参考值下限,不纳入研究,最终纳入59例患者,其中15~20岁3例、21~25岁13例、26~30岁15例、31~35岁14例、36~40岁7例、41~45岁7例;^(131)I治疗剂量≤100 mCi的患者24例、>100 mCi的患者35例,分析治疗后各时间点AMH下降率及其与患者年龄和治疗剂量的相关性。结果治疗后4 d、3个月和6个月患者AMH水平均较治疗前1 d降低,平均下降率分别为2.47%、41.7%和32.33%。AMH下降率与年龄无明显相关性(P>0.05),而与治疗剂量有相关性(P<0.05)。不同剂量组治疗后4 d AMH下降率比较差异无统计学意义(P>0.05);治疗剂量>100 mCi组治疗后3个月、治疗后6个月AMH下降率明显高于治疗剂量≤100 mCi组(均P<0.05)。治疗后3个月,各年龄组AMH下降率均高于治疗后4 d;治疗后6个月,41~45岁年龄组AMH下降率高于治疗后3个月,其余年龄组低于治疗后3个月。结论^(131)I内照射治疗可导致AMH水平显著下降,对女性的卵巢储备功能有一定影响,其下降程度和恢复状况与^(131)I的使用剂量相关。对于不同年龄段患者,^(131)I治疗导致的卵巢储备功能下降程度有所不同。。Objective To analyze the serum anti-Müllerian hormone(AMH)levels in female patients with differentiated thyroid cancer(DTC)treated with iodine-131 internal radiation to find out the extent of treatment damage to patients’ovaries and the recovery of ovarian function after treatment.Methods A total of 73 female patients with DTC,who underwent iodine-131 internal radiation therapy for the first time,were selected,with regular menstrual periods and no obvious abnormalities of ovarian function.The serum AMH levels were measured 1 d before the iodine-131 treatment,and 4 d,3 months and 6 months after treatment,among which 14 patients had AMH values below the lower limit of the reference value before treatment and were excluded from the study.59 patients were finally included,3 patients aged 15-20 years,13 patients aged 21-25 years,15 patients aged 26-30 years,14 patients aged 31-35 years,7 patients aged 36-40 years,and 7 patients aged 41-45 years;the decline rate of AMH at various time points after treatment and its correlation with patient age and treatment dose were analyzed in 24 patients who had iodine-131 dose≤100 mCi and 35 patients who had iodine-131 dose>100 mCi.Results The AMH levels in patients were reduced at 4 d,3 months and 6 months after treatment compared with 1 d before treatment,with an average decrease rate of 2.47%,41.7%and 32.33%,respectively.The decline rate of AMH was not significantly correlated with age(P>0.05),but was correlated with treatment dose(P<0.05).There was no statistically significant difference in the decrease rates of AMH 4 d after treatment between different dose groups(P>0.05);the AMH decline rate at 3 and 6 months after treatment in the treatment dose>100 mCi group was significantly higher than that in the treatment dose≤100 mCi group(both P<0.05).The decline rates of AMH in all age groups at 3 months after treatment were higher than those 4 d after treatment;the decline rate of AMH in the 41-45 age group at 6 months after treatment was higher than that at 3 months after tr

关 键 词：分化型甲状腺癌 ^(131)I内照射治疗 血清抗缪勒氏管激素 卵巢储备功能 

分 类 号：R736.1[医药卫生—肿瘤]