骨髓移植预处理对血液病患者甲状腺及肾上腺皮质功能的影响

目的：研究血液病患者骨髓移植（ＢＭＴ）后的生活质量。方法：用放射免疫法对２９例血液病患者ＢＭＴ前后垂体－甲状腺功能及肾上腺皮质功能进行了检测。结果：患者ＢＭＴ前甲状腺功能及肾上腺皮质功能正常，ＢＭＴ后３，６，１２，２４～６０个月不同时间点血清促甲状腺激素（ＴＳＨ）水平较ＢＭＴ前明显升高。ＢＭＴ后２４例患者肾上腺皮质功能均正常，６例表现有甲状腺功能异常（其中甲状腺机能减退５例，甲状腺机能亢进１例），中位发生时间为ＢＭＴ后６个月。结论：ＢＭＴ预处理对肾上腺皮质功能无明显影响，ＢＭＴ后甲状腺功能异常较常见。认为对代偿性甲状腺功能减退者先密切观察１～２年，如不能恢复正常，则应考虑给予替代治疗；长期对甲状腺功能进行随访十分重要。

Effect of bone marrow transplantation conditioning regimen on thyroid and adrenocortical functions in patients with blood diseases

OBJECTIVE: In order to investigate the life quality of patients with hematological diseases after bone marrow transplantation (BMT). METHODS: Pituitary-thyroid and adrenocortical function were de tected in 29 patients with hematological diseases before and after BMT. RESULTS: All patients had normal thyroid and adrenocortical functions before BMT. As compared with pre-BMT,the median serum TSH levels were significantly increased at 3, 6, 12 (P<0.01), 24-60 (P<0.05) months post-BMT. The adrenocortical function had no change in all patients, and thyroid dysfunction were found in 6 of 24 patients detected at a median time of 6 month post-BMT. Five of the 6 thyroid dysfuntion patients developed hypothyroidism, and one hyperthyroidism. CONCLUSION: There was little effect of conditioning regimen on adrenocortical function, while thyroid dysfunction was common after BMT. Long term follow up on thyroid function in patients after BMT is necessary.