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目的探讨~(131)I联合促甲状腺激素(TSH)抑制治疗对术后分化型甲状腺癌(DTC)患者骨生化及骨密度(BMD)的影响。方法 DTC术后患者44例分为男性组(A组,12例)、绝经前女性组(B组,21例)和绝经后女性组(C组,11例),均于术后口服~(131)I 100mCi行清除残余甲状腺和甲状腺素片行TSH抑制治疗(目标:TSH<0.1mU/L)。血钙浓度低且甲状旁腺激素(PTH)低的17例患者补充钙剂1000mg/d。治疗前后测定骨生化指标及腰椎(L1~L4)、左股骨颈、左大转子、左沃氏三角区的BMD。结果年龄影响治疗后的BMD。治疗后,ALP与L1~L4和左沃氏三角区的BMD呈负相关(P<0.05),骨钙素和Δ钙与左大转子的BMD呈负相关(P<0.05)。补钙组与未补钙组间各项骨生化指标及ΔBMD无统计学差异(P>0.05)。结论短期~(131)I联合TSH抑制治疗对术后DTC患者骨生化及BMD的影响较小,BMD下降可能与成骨细胞活性增加有关。
Objective To investigate the effect of ~ (131) I combined with thyroid-stimulating hormone (TSH) suppressive therapy on bone biochemistry and bone mineral density (BMD) in patients with differentiated thyroid carcinoma (DTC). Methods Forty - four patients with postoperative DTC were divided into male group (group A, n = 12), premenopausal female group (group B, n = 21) and postmenopausal female group (group C, n = 11) 131) I 100mCi removal of residual thyroid and thyroid tablets TSH inhibition of treatment (target: TSH <0.1mU / L). Seventeen patients with low serum calcium and low parathyroid hormone (PTH) were supplemented with 1000 mg of calcium. Before and after treatment of bone biochemical indicators and lumbar (L1 ~ L4), left femoral neck, left greater trochanter, left Waugh’s triangle BMD. Results Age affected BMD after treatment. After treatment, ALP was negatively correlated with BMD of L1 ~ L4 and Zuogou’s triangle area (P <0.05), while osteocalcin and ΔCa negatively correlated with BMD of left great trochanter (P <0.05). Calcium group and non-calcium group bone biochemical indicators and ΔBMD no significant difference (P> 0.05). Conclusions Short-term ~ (131) I combined with TSH suppressive therapy has little effect on bone biochemistry and BMD in postoperative DTC patients, and the decrease of BMD may be related to the increase of osteoblast activity.