【摘要】 目的探讨¹³¹I联合促甲状腺激素（TSH）抑制治疗对绝经后分化型甲状腺癌（DTC）术后患者血清甲状旁腺激素（PTH）、血钙（Ca）、股骨颈骨密度及T淋巴细胞亚群水平的影响。方法选择2017年5月至2017年10月间吉林大学第一医院核医学科收治的绝经后DTC术后（甲状腺全切或近全切）患者56例,全部为中高复发危险度,给予¹³¹I+TSH抑制治疗（口服左甲状腺素片,控制血清TSH<0.1mU/L）及预防性钙和维生素D治疗,随访1～1.5年。比较患者治疗前后PTH、Ca、股骨颈骨密度、CD4⁺、CD8⁺、CD4⁺/CD8⁺指标的变化。结果 CD4⁺、CD8⁺、CD4⁺/CD8⁺指标变化具有显著性差异（P<0.05）;PTH、Ca、股骨颈骨密度指标变化无显著性差异（P>0.05）。结论绝经后DTC术后患者给予¹³¹I+TSH抑制治疗能够改善机体细胞免疫功能;给予预防骨质流失治疗可以一定程度上减少TSH抑制治疗对骨质流失的影响;值得临床推广应用。更多还原

【Abstract】 Objective To study the effect of ¹³¹I treatment combined with TSH inhibition on levels of the serum PTH,Ca²⁺,peripheral blood T lymphocyte subsets（CD4⁺,CD8⁺） and femoral neck bone density in postmenopausal patients with DTC after surgery.Methods 56 cases of patients with DTC after the operation in the Department of Nuclear Medicine,1 ST Hospital of Jilin University from May 2017 to October 2017 were enrolled,all of whom were of moderate to high recurrence risk.They got ¹³¹I treatment combined with TSH Inhibition therapy（TSH < 0.1 mU/L） and calcium,vitamin D.After followed-up for 1～1.5 years,the clinical effects before and after treatment were analyzed and compared.Results The level of CD4⁺ after treatment was higher than that before treatment,the differences were significantly different（P<0.05）.The level of CD8⁺ after treatment was lower than that before treatment,the differences were significantly different（P<0.05）.There were no significantly differences in the levels of the serum PTH,Ca²⁺ and femoral neck BMD before and after treatment（P>0.05）.Conclusion ¹³¹I combined with TSH inhibition therapy can improve the cellular immunity function of postmenopausal patients with DTC after the surgery.Calcium and vitamin D supplementation would be considered to reduce the risk of osteoporosis in postmenopausal patients.It is worthy of clinical application.更多还原