分化型甲状腺癌清甲后患者甲状腺素撤药后血清TSH观察
Observation of Serum TSH Level After Levothyroxine Withdrawal in Patients with Post-ablation Differentiated Thyroid Carcinoma
毛夕宝 1蒋凌云 1薛宁娟1
作者信息
- 1. 苏州大学附属常州肿瘤医院,213001
- 折叠
摘要
目的:通过对分化型甲状腺癌患者甲状腺素撤药后的血清TSH的分期、定量检测,研究血清TSH在甲状腺素撤药后的变化规律及最合适撤药时间.方法:145例131I清甲治疗后6个月的分化型甲状腺癌术后患者,在甲状腺素撤药后(2~4)周,每周测定其血清TSH浓度.分组比较不同性别、年龄、病理类型患者在甲状腺素撤药后(2~4)周时血清TSH水平的差异,P>0.05表示差异有显著性.结果:①甲状腺素撤药后(2~4)周,男性组TSH水平均高于女性组,撤药时间越长,组间差异越明显(P=0.037、0.006、0.001); <45岁年龄组TSH水平均高于≥45岁年龄组,撤药时间越长,组间差异越明显(P=0.010、0.006、0.001);滤泡状癌组TSH水平均高于乳头状癌组,组间比较无统计学差异.②甲状腺素撤药后(2~4)周,男性组分别有72.2%(26/36),91.7%(33/36),100%(36/36)血清TSH>25μIU/ml,女性组分别有64.2%(70/109),86.2%(94/109),96.3%(105/109)血清TSH>25μIU/ml;<45岁年龄组分别有62.1%(36/58),93.1%(54/58),100%(58/58)血清TSH>25μIU/m,≥45岁年龄组分别有51.7%(45/87),80.5%(70/87),97.7%(85/87)血清TSH>25μIU/ml.结论:分化型甲状腺癌术后并行131I清甲治疗后的患者在甲状腺素撤药后,血清TSH水平的变化因性别及年龄而不同,甲状腺素撤药时间需根据性别和年龄而异,建议男性患者和<45岁患者在撤药后3周及时检测TSH,避免不必要的TSH水平过高及甲减副作用.
Abstract
Objective To observe the change of serum level of TSH after levothyrozine withdrawal in post-ablation differentiated thyroid carcinoma( DTC) patients. Methods 145 DTC patients with total or subtotal thyroidectomy who received radioiodine ablation 6 months before were included in this study. For the reason of monitoring of recurrence and metastasis, all the patients were informed levothyrozine withdrawal. The serum level of TSH was measured dynamically once a week after 2 weeks of levothyroxine withdrawal. A-mong these patients, there were 36 males and 109 females with an average age of 44.72 ± 12.36 years. The patients were classified in to different groups according to gender and age. The difference of serum TSH level showed significant if p value was less than 0. 05. Results ①After 2-4 weeks of levothyrozine withdrawal, the serum TSH level proved higher in the group of male patients (P = 0.037,0.006,0.001), the group of younger patients(P=0.010,0.006,0.001) and the group of follicular thyroid cancer patients (P =0.483,0.327,0.389). ② After 2-4 weeks of levothyrozine withdrawal, the percentage of patients whose serum TSH levels were more than 25μIU/ml was 72.2%, 91.7% and 100% in male patients respectively; 64.2%, 86.2% and 96.3% in female patients individually; 62.1%, 93.1% and 100% in younger patients; 51.7% , 80.5% and 97.7% in elder patients seperately. Conclusions The change of serum TSH level after levothyrozine withdrawal in the post-ablation thyroid carcinoma patients varies with the patients' gender and age. The patients of male and younger ages should be advised to measure the serum TSH level 3 weeks after the levothyroxine withdrawal to avoid the unnecessary high TSH level and the apparent side-effect of hypothyroidism.
关键词
分化型甲状腺癌/清甲治疗/促甲状腺激素/甲状腺素撤药Key words
differentiated thyroid carcinoma/radioiodine ablation/thyroid stimulating hormone/levothyroxine withdrawal引用本文复制引用
出版年
2013
NETL
NSTL
维普
万方数据