【摘要】 目的：分析鼻咽癌放疗对甲状腺功能的影响。方法：１９９２年１月～１９９６年１２月，对５０例鼻咽癌患者放疗后甲状腺功能进行了前瞻性研究，采用放免法测定放疗前、放疗终及放疗后不同时期血清ＴＴ３、ＴＴ４、ＦＴ３、ＦＴ４及ＴＳＨ水平。结果：放疗后，血清ＴＴ３即明显低于放疗前的水平。放疗后１年，ＴＴ４及ＦＴ３水平亦降低，放疗后３年，ＴＴ３、ＴＴ４、ＦＴ３、ＦＴ４均明显低于疗前水平（Ｐ＜０．０５）。放疗后，血清ＴＳＨ水平并无明显升高，放疗３年后，总体呈下降趋势（Ｐ＞０．０５）。放疗终８％的患者ＴＳＨ高于正常水平，至放疗后１年达１９．６％，同时，放疗后１年、２年及５年，血清ＴＳＨ水平低于正常者为４．３％、１１．４％及２８．６％。５年中共发生９例临床甲状腺功能低下甲低病例，其中，ＴＳＨ低于正常者４例，位于正常者４例，高于正常者１例。结论：鼻咽癌放疗后，甲状腺功能受损及垂体功能低下是造成临床甲低的两个主要因素。更多还原

【Abstract】 Purpose: To analyze the radiotherapeutic affect to thyroid function in NPC patients. Methods: Serum TT 3, TT 4, FT 4 and TSH were determined in 50 patients with NPC before and after radiotherapy, from January 1992 to December 1996. Results: After receiving radiotherapy, the serum TT 3 lowered significantly.The levels of TT 4 and TT 3 declined one year after irradiation.All the levels of TT 3, TT 4, FT 3, FT 4 lowered significantly than those before treatment( P <0.05). The serum TSH level remained unchanged after irradiation, but it tended to decline 3 years later ( P >0.05). At the end of therapy, the level of TSH in 8% of the patients were higher than normal, but the percentage of the patients escalated to 19.6% one year after radiotherapy. Meanwhile, the percentage of the patients with low TSH at 1 , 2 , 5 year were 4.3%, 11.4% and 28.6% respectively. There were 9 cases of clinical hypothroidism, of whom subnormal TSH was found in 4, normal TSH in 4 and high TSH in 1. Conclusion: It is thought that impaired thyroid function and hypopituitarism are the chief causes of clinical hypothyroidism after radiotherapy of NPC.更多还原