| 李招霞 赵会文 苏宁 付正菊 许士璐 牛风秀 宋晓琪.甲状腺癌术后短期甲状腺功能低下对骨代谢的影响[J].,2016,16(24):4647-4650 |
| 甲状腺癌术后短期甲状腺功能低下对骨代谢的影响 |
| Effect of Short-termthyroid Hypofunction after Operation on the BoneMetabolismin Patients with Thyroid Carcinoma after Operation |
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| DOI： |
| 中文关键词: 甲状腺癌 131I 甲状腺功能低下 骨代谢 |
| 英文关键词: Thyroid cancer 131I Hypothyroidism Bone Metabolism |
| 基金项目:国家自然科学基金项目（81441041）；青岛市市南区科技发展项目（2014-14-027YY） |
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| 中文摘要: |
| 目的：观察分化型甲状腺癌(DTC)患者手术后、碘131(131I)清甲治疗前停用甲状腺素造成的短期甲减对骨代谢的影响。方法：
选择DTC术后患者53 例作为试验组，50 例健康人作为对照组，试验组于停服甲状腺素第二天空腹采血行游离甲状腺素(FT4)、
游离三碘甲状腺原氨酸(FT3)、促甲状腺激素(TSH)、血钙(Ca)、血磷(P)、血清碱性磷酸酶(ALP)、血清骨钙素(BGP)，I 型前胶原羧基
末端前肽(PICP)、I型胶原交联羧基末端肽(ICTP)等各项检查，停服甲状腺素4 周后于131I 治疗前再行上述检查，对照组于体检当
日采空腹血测相同项目。结果：试验组患者停药前血清FT3、FT4 水平明显高于对照组，差异有统计学意义(P<0.05)。停服甲状腺素
后，试验组患者血清TSH 升高，T3、T4 水平降低，血BGP、血Ca、PICP、ICTP 水平降低，与停药前及对照组的检验结果相比均有明
显差异(P<0.05)。停药后，骨密度与停药前比较差异无统计学意义(P>0.05)。停服甲状腺素前后血磷水平无明显变化，与对照组相
比也没有明显差异(P>0.05)。结论：甲状腺癌术后造成甲状腺功能低下可明显影响患者骨代谢，应于131I后及时给予甲状腺激素，
及时纠正甲低状态，同时也可适量补充钙剂。 |
| 英文摘要: |
| Objective:Observe the short-term effect of hypothyroidism on bone metabolism in Patients with differentiated thyroid
cancer (DTC) after surgery,before iodine 131 (131I) treatment withdrawal the Thyroid hormone.Methods:53 patients with DTC as
experimental group, 50 healthy subjects were selected as the control group, The experimental group in the second day of withdrawal of
thyroid hormone blood for free thyroxine (FT4), free triiodothyronine triiodothyronine (FT3), promote thyroid stimulating hormone
(TSH), calcium (Ca), phosphorus (P), serumalkaline phosphatase (ALP), SerumOsteocalcin (BGP), type I collagen carboxyterminal
propeptide (PICP), type I collagen cross-linked carboxy terminal peptide (ICTP) etc. examinations, withdrawal of thyroid hormone for 4
weeks before 131I treatment and then do the above examination, Control group on the Physical examination day for the same project.Results:The level of serum FT3, FT4 in the test group were significantly higher than that in the control group, the difference was
statistically significant (P<0.05). withdrawal of thyroid hormone, the experimental group of patients with elevated serum TSH, T3, T4
levels decreased, BGP, Ca, PICP, ICTP levels decreased. There was a significant difference compared with the control group and before
the drug withdrawal (P<0.05). Bone density was not statistically significant after the withdrawal of thyroid hormone or not, (P>0.05).
There was no significant change in serum phosphorus level before and after the withdrawal of thyroid hormone, Compared with the
control group, there was no significant difference (P>0.05).Conclusion:Thyroid function caused by thyroid cancer after operation can
obviously affect the patient's bone metabolism, So the thyroid hormone should be given in time after 131I, Correct hypothyroid timely, At
the same time, it should be a moderate amount of calciumsupplements. |
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