促甲状腺激素抑制治疗对分化型甲状腺癌术后的疗效及安全性分析

目的 对分化型甲状腺癌术后患者采取促甲状腺激素抑制治疗,分析其疗效及安全性.方法 选取100例甲状腺癌患者,行手术治疗后随机分为两组,抑制组给予促甲状腺激素抑制治疗,替代组给予甲状腺激素替代治疗,观察其复发、转移率及不良反应情况.结果 抑制组术后3年1例复发,术后5年3例复发,术后10年4例复发,明显少于替代组,差异有统计学意义(P<0.05);抑制组术后3年颈部淋巴结转移1例,远处转移1例,术后5年颈部淋巴结转移1例,远处转移2例,术后10年颈部淋巴结转移2例,远处转移2例,均明显少于替代组,差异有统计学意义(P<0.05);抑制组发热占2%,骨质疏松占2%,心率异常为6%,震颤占2%,皮疹占2%,总发生率为14%,而替代组总发生率为32%,抑制组低于替代组,差异有统计学意义(P<0.05).结论 对分化型甲状腺癌术后患者采用TSH抑制治疗,能够更明显的降低近期、远期复发及转移率,且不良反应轻微,值得临床广泛推广应用.

Analysis of the Efficacy and Safety of Thyroid Stimulating Hormone in the Treatment of Differentiated Thyroid Carcinoma After Operation

Objective To evaluate the efficacy and safety of thyroid stimulating hormone ( TSH) in patients with differ-entiated thyroid carcinoma after operation .Methods 100 patients with thyroid carcinoma were randomly divided into 2 groups .In the inhibition group ,TSH treatment was given .Thyroid hormone replacement therapy was used in the replacement group .The re-currence rate ,metastasis rate and adverse reaction were observed .Results The recurrence was found in 3 cases in 3 years after operation,3 cases in 5 years after operation and 4 cases in 10 years after operation in the inhibition group ,which was significantly lower than those of replacement group (P<0.05).In the inhibition group,there had 1 case of cervical lymph node metastasis ,1 case of distant metastasis in 3 years,1 case of cervical lymph node metastasis ,2 cases of distant metastasis in 5 years,2 cases of cervical lymph node metastasis,2 cases of distant metastasis in 10 years,(P<0.05).In the inhibition group,fever was 2%,oste-oporosis was 2%,heart rate was 6%,tremor was 2%and rash was 2%.The overall incidence was 14%,While the total incidence of substitution group was 32%,the inhibition group was lower than the replacement group ,the difference was statistically signifi-cant(P<0.05).Conclusion TSH can reduce the short-term and long-term recurrence and metastasis rates of patients with dif-ferentiated thyroid carcinoma after TSH ,and the adverse reaction is mild ,it is worthy of wide application in clinic .