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使用重组促甲状腺激素进行I-131闪烁扫描准备是否会影响听力功能?

Does the use of recombinant TSH in preparation for I-131 scintigraphy scan affect hearing function?

作者信息

Doğan Mehtap, Durmuş Kasım, Hasbek Zekiye, Altuntaş Emine Elif

机构信息

Department of Otolaryngology, Faculty of Medicine Cumhuriyet University 58140, Sivas, Turkey.

Cumhuriyet Univ. School of Medicine, Dept. of Nuclear Medicine, Campus, 58140, Sivas, Turkey.

出版信息

J Otol. 2018 Mar;13(1):20-24. doi: 10.1016/j.joto.2017.10.001. Epub 2017 Oct 13.

Abstract

OBJECTIVE

The objective of this study was to examine the effect of hypothyroidism on hearing function in patients surgically treated for differentiated thyroid cancer and subsequently experienced hypothyroidism during preparation for follow up I-131 scintigraphy scan by either recombinant human thyroid stimulating hormone (rhTSH) treatment or thyroid hormone withdrawal (THW).

METHODS

A total of 55 patients undergoing I-131 scintigraphy scan following surgeries for differentiated thyroid cancer were included in the study, including 25 patients prepared by administration of recombinant TSH (rhTSH Group) and 30 patients by thyroid hormone withdrawal (THW Group).

RESULTS

Air conduction thresholds at 1, 2 and 4 kHz for both ears were higher during hypothyroid period than during euthyroid period for patients in the THW group (p < 0.05) but not for patients in the rhTSH group.

CONCLUSION

Sensorineural hearing loss was detected, especially at low frequencies, in patients with DTC after surgical treatment whose hormone replacement therapy was withdrawn but not in those receiving rhTSH. It is therefore preferred to use rhTSH when preparing for I-131 scintigraphy scan in patients at risk for hearing loss.

摘要

目的

本研究的目的是探讨甲状腺功能减退对接受分化型甲状腺癌手术治疗且在后续进行I - 131闪烁扫描准备过程中因重组人促甲状腺激素(rhTSH)治疗或甲状腺激素撤减(THW)而出现甲状腺功能减退的患者听力功能的影响。

方法

本研究共纳入55例分化型甲状腺癌手术后接受I - 131闪烁扫描的患者,其中25例通过给予重组促甲状腺激素进行准备(rhTSH组),30例通过甲状腺激素撤减进行准备(THW组)。

结果

THW组患者在甲状腺功能减退期双耳1、2和4kHz的气导阈值高于甲状腺功能正常期(p < 0.05),而rhTSH组患者则无此情况。

结论

在接受手术治疗的分化型甲状腺癌患者中,撤减激素替代治疗的患者出现了感音神经性听力损失,尤其是在低频,但接受rhTSH治疗的患者未出现。因此,对于有听力损失风险的患者,在准备I - 131闪烁扫描时,首选使用rhTSH。

相似文献

本文引用的文献

1
The Surgical Approach to Differentiated Thyroid Cancer.分化型甲状腺癌的手术治疗方法
F1000Res. 2015 Nov 27;4. doi: 10.12688/f1000research.7002.1. eCollection 2015.
4
Cochlear dysfunction in patients with acute hypothyroidism.急性甲状腺功能减退症患者的耳蜗功能障碍。
Eur Arch Otorhinolaryngol. 2013 Nov;270(11):2839-48. doi: 10.1007/s00405-012-2332-9. Epub 2012 Dec 25.
5
Hearing profile in hypothyroidism.甲状腺功能减退症的听力状况
Indian J Otolaryngol Head Neck Surg. 2002 Oct;54(4):285-90. doi: 10.1007/BF02993744.
8
Molecular nuclear therapies for thyroid carcinoma.甲状腺癌的分子核疗法。
Methods. 2011 Nov;55(3):230-7. doi: 10.1016/j.ymeth.2011.06.002. Epub 2011 Jun 16.

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