分化型甲状腺癌术后TSH抑制对骨密度的影响研究

洪浩

【摘 要】目的：探究分化型甲状腺癌术后TSH抑制对骨密度的影响。方法：择取2017年7月至2018年9月期间我院收治的65例分化型甲状腺癌手术患者，根据患者复发风险程度分为低危组38例和中高危组27例，两组均行术后TSH抑制，比较两组患者手术前后不同部位骨密度。结果：两组患者术前股骨颈、髋关节骨密度差异无统计学意义（P>0.05）;两组术后相比本组术前骨密度下降，且中高危组患者术后股骨颈骨密度低于低危组，差异有统计学意义（P<0.05）。结论：患者术后进行TSH抑制会使得其骨密度下降，尤其是对髋关节和股骨颈的影响更显著。

【关键词】分化型甲状腺癌;TSH抑制;骨密度

【中图分类号】R736.1 【文献标识码】B 【文章编号】1002-8714（2020）04-0127-02

【Abstract】Objective：To investigate the effect of postoperative TSH inhibition on bone mineral density in differentiated thyroid cancer.Methods：A total of 65 patients with differentiated thyroid cancer who were treated in our hospital from July 2017 to September 2018 were selected.They were divided into 38 low-risk groups and 27 high-risk groups according to the risk of recurrence.Postoperative TSH inhibition was compared between different groups of patients before and after surgery.Results：There was no significant difference in the bone mineral density of the femoral neck and hip joints between the two groups of patients before surgery （P> 0.05）. The bone density of the two groups decreased after surgery compared with this group， and the femoral neck bone density of the patients in the middle and high risk groups was lower than The difference was statistically significant in the low-risk group （P <0.05）.CONCLUSION：Inhibition of TSH in patients after surgery will reduce their bone density，especially in the hip joint and femoral neck.

【keywords】differentiated thyroid cancer;TSH inhibition;bone mineral density

分化型甲狀腺癌（DTC）是常见内分泌恶性肿瘤类型，具有较高死亡率。该疾病可进行根治术治疗，术后需要长期通过左旋甲状腺素片调节负反馈，降低促甲状腺素（TSH）浓度，以降低患者远期复发率[1-2]。抑制TSH一般需要外源性甲状腺激素给药，可能造成患者骨密度改变，为探究DTC患者术后抑制TSH对其骨密度的影响，本次择取65例患者开展相关研究，具体如下：

1 资料与方法

1.1一般资料

择取2017年7月至2018年9月期间我院收治的65例分化型甲状腺癌手术患者，根据患者复发风险程度分为低危组38例和中高危组27例，低危组年龄35～71岁，平均（53.6±2.5）岁，中高危组年龄33～72岁，平均（53.2±2.6）岁，组间一般资料经比较无统计学意义（P>0.05），可比。

1.2方法

两组均行术后TSH抑制，单、双侧手术患者术后均行左甲状腺素片给药，每日给药总剂量分别为75ug和125ug，每月检测1次甲状腺激素水平，每次给药剂量调整范围在12.5到50ug。低危组TSH控制范围为0.1～0.5mU/L，中高危组TSH控制范围为0.1mU/L以内。