分化型甲状腺癌患者停用左甲状腺素片后血脂变化及相关性分析  

Changes and Correlation Analysis of Blood Lipids in Patients with Differentiated Thyroid Cancer After Discontinuation of Levothyroxine Tablets

作　　者：贺旖君 陈伟娜 贾静 He Yijun;Chen Weina;Jia Jing(Zhengzhou University First Affiliated Hospital,Zhengzhou,Henan,450003,China)

机构地区：[1]郑州大学第一附属医院,河南郑州450003

出　　处：《黑龙江医学》2025年第7期774-776,共3页Heilongjiang Medical Journal

摘　　要：目的:统计分化型甲状腺癌(DTC)患者术前及经过手术+131 I治疗+T4治疗后停用甲状腺素片后的血脂及甲状腺激素水平,分析其变化规律及相关性并提出改进措施。方法:选取2022年11月—2023年11月郑州大学第一附属医院复查的345例分化型甲状腺癌患者作为研究对象。复查前需停用左甲状腺素钠片4周左右(25~31 d),复查时抽血化验患者的血清游离三碘甲酰原氨酸(FT3)、血清游离甲状腺素(FT4)、促甲状腺素(TSH)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、血压水平,统计患者手术前的上述化验结果,对数据进行分析讨论。结果:手术前患者的LDL与FT4呈负相关(rs=-0.120,P<0.05),收缩压与FT3呈正相关(rs=0.109,P<0.05),血脂水平其他指标与甲状腺功能无相关性(P>0.05)。停服左甲状腺素钠片4周左右复查时,患者的FT3、FT4水平较术前下降,TSH水平升高,TC、TG、HDL、LDL均较术前升高,患者的甲状腺功能减退,FT3、FT4下降,TSH升高,差异均有统计学意义(t=-35.832、-13.816、-10.974、-32.214、-7.226、-16.827、-12.415,P<0.05);TC、TG与FT4呈负相关(P<0.05),TC、TG、HDL、LDL、SP与TSH呈正相关(P<0.05)。结论:分化型甲状腺癌患者,停用左旋甲状腺素钠片4周左右后,甲状腺激素水平降低,血脂水平升高,在此期间应指导患者摄取低脂低碘高维生素饮食,医护结合,改善患者的血脂水平,降低并发症发生的风险。Objective:To statistically analyze the levels of blood lipids and thyroid hormones in patients with differentiated thyroid cancer(DTC)before surgery and after discontinuation of thyroxine(surgery+131 I treatment+T4 treatment),analyze their changes and correlation,and propose improvement measures.Methods:A total of 345 patients with differentiated thyroid cancer who were re-examined in the First Affiliated Hospital of Zhengzhou University from November 2022 to November 2023 were selected as the study objects.Levothyroxine sodium tablets should be stopped for about 4 weeks(25~31 days)before review.The serum free triiodoformionine(FT3),serum free thyroxine(FT4),thyrotropin(TSH),total cholesterol(TC),triglyceride(TG),high density lipoprotein(HDL),low density lipoprotein(LDL),and blood pressure of the patients were tested.The above laboratory results before surgery were analyzed and discussed.Results:There was negative correlation between LDL and FT4 in patients before surgery(rs=-0.120,P<0.05),and positive correlation between systolic blood pressure and FT3(rs=0.109,P<0.05).There was no correlation between other indicators of blood lipid levels and thyroid function(P>0.05).When taking levothyroxine sodium tablets for about 4 weeks(25~31 days)for follow-up,the patient’s FT3 and FT4 levels decreased compared to before surgery.TSH levels,total cholesterol(TC),triglycerides(TG),high-density lipoprotein(HDL)and low density lipoprotein(LDL)levels were significantly elevated compared to preoperative levels(t=-35.832,-13.816,-10.974,-32.214,-7.226,-16.827,-12.415;P<0.05).There was negative correlation between TC,TG,and FT4(P<0.05),while TC,TG,HDL,LDL,SP were positively correlated with TSH(P<0.05).Conclusion:In patients with differentiated thyroid cancer,after discontinuing levothyroxine sodium tablets for about 4 weeks,thyroid hormone levels decrease,and blood lipid levels increase.During this period,patients should be guided to consume a low-fat,low iodine and high vitamin diet;combine with medical care;improve their bloo

关 键 词：甲状腺癌 左甲状腺素钠片 血脂 饮食护理 

分 类 号：R736.1[医药卫生—肿瘤]