左甲状腺素钠联合I 131治疗甲状腺切除术后患者的临床疗效及其对甲状腺球蛋白和促甲状腺激素水平的影响。
Clinical Efficacy of Levothyroxine Sodium plus I 131 in the Treatment of Patients with Thyroidectomy and Its Effect on the Levels of Thyroglobulin and Thyrotropin.
作者信息
Pang Ya-Ling, Wang Yan-Ping, Cheng Kun
机构信息
Department of Endocrinology, Shaanxi Provincial People's Hospital, Xi'an 710068, China.
Department of Clinical Laboratory, Baodi District People's Hospital, Tianjin 301800, China.
出版信息
Evid Based Complement Alternat Med. 2022 Aug 2;2022:9557061. doi: 10.1155/2022/9557061. eCollection 2022.
OBJECTIVE
This study was to evaluate the clinical efficacy of levothyroxine sodium tablets combined with I 131 in the treatment of patients after thyroidectomy and the effect on thyroglobulin (Tg) and thyroid stimulating hormone (TSH) levels.
METHODS
80 patients with differentiated thyroid cancer who required thyroidectomy after surgery between July 2019 and January 2021 were recruited for prospective study, 40 patients in the control group received levothyroxine sodium tablets, and 40 patients in the experimental group received levothyroxine sodium treatment plus I 131 treatment. Treatment effect, serum Tg and TSH levels, and relapse were measured.
RESULTS
The removal rate of residual thyroid tissue in the experimental group (87.50%) was significantly higher than that in the control group (57.50%) ( < 0.05). Levothyroxine sodium tablets plus I 131 was associated with a significantly higher efficacy versus levothyroxine sodium tablets ( < 0.05). There were no significant differences in the serum Tg levels between the two groups before treatment ( > 0.05). After treatment, the serum Tg levels in both groups were significantly decreased, and levothyroxine sodium tablets plus I 131 resulted in a significantly lower Tg level versus levothyroxine sodium tablets ( < 0.05). Before treatment, the two groups showed similar TSH levels ( > 0.05). After treatment, patients receiving levothyroxine sodium tablets plus I 131 had a significantly greater increase in the TSH levels versus levothyroxine sodium tablets ( < 0.05). The recurrence rate of the experimental group was lower than that of the control group ( < 0.05).
CONCLUSION
Levothyroxine sodium tablets plus I 131 for post-operative patients with differentiated thyroid cancer enhance the removal rate of residual thyroid tissue, effectively reduce serum Tg level, and increase TSH level, with significant therapeutic effects, low recurrence rates, and a high safety profile.
目的
本研究旨在评估左甲状腺素钠片联合碘131治疗甲状腺切除术后患者的临床疗效以及对甲状腺球蛋白（Tg）和促甲状腺激素（TSH）水平的影响。
方法
选取2019年7月至2021年1月间80例术后需要甲状腺切除的分化型甲状腺癌患者进行前瞻性研究，对照组40例患者接受左甲状腺素钠片治疗，实验组40例患者接受左甲状腺素钠治疗加碘131治疗。测量治疗效果、血清Tg和TSH水平以及复发情况。
结果
实验组残余甲状腺组织清除率（87.50%）显著高于对照组（57.50%）（P<0.05）。左甲状腺素钠片加碘131治疗的疗效显著高于左甲状腺素钠片（P<0.05）。治疗前两组血清Tg水平无显著差异（P>0.05）。治疗后，两组血清Tg水平均显著降低，且左甲状腺素钠片加碘131治疗后的Tg水平显著低于左甲状腺素钠片（P<0.05）。治疗前，两组TSH水平相似（P>0.05）。治疗后，接受左甲状腺素钠片加碘131治疗的患者TSH水平升高幅度显著大于左甲状腺素钠片治疗患者（P<0.05）。实验组复发率低于对照组（P<0.05）。
结论
左甲状腺素钠片联合碘131用于分化型甲状腺癌术后患者可提高残余甲状腺组织清除率，有效降低血清Tg水平，升高TSH水平，治疗效果显著，复发率低，安全性高。
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