摘要/Abstract
摘要： 目的·观察分化型甲状腺癌（differentiated thyroid cancer，DTC）患者在停用左旋甲状腺激素所致的一过性甲状腺功能减退（简称甲减）状态下肝功能、血脂及血常规的变化。方法·收集行甲状腺癌根治术及131I治疗的182例患者术前（甲状腺功能正常）和术后甲减状态（停用甲状腺素3～ 4周，促甲状腺激素 > 30 mU/L）的肝功能、血常规、血脂等测定结果。将患者按照年龄分为3组：青年组（< 30岁）26例，中年组（30～ 54岁）112例，老年组（≥ 55岁）44例。比较手术前后以及不同组别患者各项指标的差异。结果·碘治疗前甲减状态下患者的谷丙转氨酶、谷草转氨酶、乳酸脱氢酶及胆汁酸均有升高（均P<0.05），而血清直接胆红素和总胆红素水平出现下降（均P<0.05），三酰甘油、总胆固醇、高密度脂蛋白、低密度脂蛋白升高（均P<0.05），红细胞与血红蛋白轻度升高。青年组碘治疗前甲减状态下，谷丙转氨酶、谷草转氨酶、乳酸脱氢酶、胆汁酸升高较中年组及老年组更为显著（均P<0.05）。结论· DTC患者停用左旋甲状腺激素所致的一过性甲减状态会引起肝酶异常、血脂水平升高，临床工作中需予以重视。
关键词: 分化型甲状腺癌, 放射性碘, 肝功能异常, 甲状腺功能减退
Abstract:
Objective · To investigate the effect of temporary hypothyroidism state to liver function, serum lipid and blood routine in patients with differentiated thyroid cancer (DTC) prepared for radioactive iodine treatment. Methods · A total of 182 patients with DTC undergoing radical operation of thyroid cancer and radioactive iodine treatment were collected. All these patients were divided into 3 groupsage: 26 in young group (<30 years), 112 in middle-aged group (30-54 years) and 44 in elderly group (≥55 years). Indicators of liver function, blood lipids and blood routine were compared before and after operation, among groups as well. Results · Patients under hypothyroidism state had significantly elevations in ALT, AST, LDH and serum bile acid, but a nodecrease of serum bilirubin (all P<0.05). Meanwhile they had remarkable elevations in triglyceride, cholesterol, LDL and HDL (all P<0.05). In the young group before thyroid hypothyroidism treatment, the elevation of ALT, AST, LDH and serum bile acid were more significant than those of the middle-aged and elderly patients (all P<0.05). Conclusion · The temporary hypothyroidism state of differentiated thyroid cancer patients could elevate liver enzymes as well as dyslipidemia.
Key words: differentiated thyroid cancer, iodine radioisotopes, liver dysfunction, hypothyroidism
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