分化型甲状腺癌患者激素水平及促甲状腺激素抑制治疗分析.PDFVIP

《中国医学前沿杂志 （电子版）》2015 年第7 卷第11 期 ● 论著 ● 81 分化型甲状腺癌患者激素水平及促甲状腺 激素抑制治疗分析 1 1 2 王霞 ，张瑞明 ，高权荣 （1．内蒙古医科大学附属医院　普外科，呼和浩特　010059 ；2 ．内蒙古医科大学， 呼和浩特　010059 ） 【摘要】目的 探讨分化型甲状腺癌患者激素水平，并以此为依据来确定促甲状腺激素 （TSH ）抑制治 疗的介入时间及指导用药。方法 选择本院收治的分化型甲状腺癌患者130 例为研究对象，均为初次 治疗，采用电化学发光免疫法分析患者术后激素水平，按照术式将其分为A 、B 两组，每组各65 例。 A 组患者行全甲状腺切除，B 组患者行单侧腺叶与峡部切除。采集两组患者术后2 、4 、7 及14 天空腹 静脉血分析甲状腺相关激素水平，至TSH 水平＞2 mU/L 时为止，此时采取TSH 抑制治疗并指导用药。 结果 A 组患者术后TSH 水平出现一过性下降，术后第2 天开始升高且超过术前，术后第4 天超过 正常参考值上限；B 组患者术后TSH 水平也出现一过性下降，术后第2 天开始达最低谷随后升高，至 术后第7 天开始接近术前水平，术后2 周超过术前正常参考值上限。两组患者其他甲状腺相关激素水 平均出现变化。结论 分化型甲状腺癌患者术后激素水平呈动态性变化，可依据这种变化来确定抑制 TSH 治疗的时间，但具体应参照个体情况，避免出现甲状腺功能亢进。 【关键词】分化型甲状腺癌 ；促甲状腺激素；术后抑制治疗 Analysis of hormone level and TSH suppression therapy in patients with differentiated thyroid carci- noma 1 1 2 WANG Xia , ZHANG Rui-ming , GAO Quan-rong (1. Department of General Surgery, The Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010059, China; 2. Inner Mongolia Medical University, Hohhot 010059, China) Corresponding author: ZHANG Rui-ming, E-mail: wangxi163.com Abstract Objective To investigate the hormone levels in the patients with differentiated thyroid cancer, 【 】 　 and to determine the intervention time of TSH suppression therapy. Method　130 cases of differentiated thyroid carcinoma in our hospital were selected as objects of study, all of them were treated for the first time, analyzed the hormone levels of patients after operation by electrochemical immunoassay, according to different surgical methods, they were divided into group A and group B, 65 cases in each group. Patients in group A were treated with total thyroidectmy, patients in group B were treated with one-sided lobe and isthmus resection. Analyzed 2, 4, 7, 14 days after surgery in patients with thyroid associated hormone levels in the two grou