【摘要】 目的 探讨分析碘131联合左甲状腺素钠治疗分化型甲状腺癌的临床疗效。方法 前瞻性选取2015年1月至2016年1月期间秦皇岛市第一医院收治的60例分化型甲状癌术后患者为研究对象，随机数字表法分为研究组(n=30)与对照组(n=30);其中对照组予以左甲状腺素钠进行治疗，研究组在对照组基础上联合使用碘131进行治疗。观察比较两组患者临床疗效、甲状腺功能[甲状腺刺激抗体(TSAb)、甲状腺刺激阻断性抗体(TSBAb)、促甲状腺激素受体抗体(TRAb)]、不良反应以及5年后随访了解患者复发、转移情况。结果 研究组总有效率为90.00%，明显高于对照组(73.33%)，差异有统计学意义(P <0.05)。治疗后，研究组TSAb、TSBAb、TRAb等甲状腺功能指标水平为(2.12±0.48) U/L、(9.88±2.06) U/m L、(7.40±1.31) U/L，均较对照组低[(3.22±0.75) U/L、(17.11±3.48) U/m L、(16.80±3.11) U/L]，差异均有统计学意义(P <0.05)。研究组不良反应发生率为6.67%，明显低于对照组(13.33%)，差异有统计学意义(P <0.05)。5年后经随访，研究组复发率、颈部淋巴结转移率以及远处转移率为6.67%、10.00%、10.00%，均较对照组低(23.33%、30.00%、26.67%)，差异均有统计学意义(P <0.05)。结论 碘131联合左甲状腺素钠治疗分化型甲状腺癌的效果优于左甲状腺素钠，促进甲状腺功能恢复，降低不良反应发生率，且可有效降低术后复发、转移的风险。更多还原

【Abstract】 Objective To explore and analyze the clinical efficacy of iodine 131 combined with levothyroxine sodium in the treatment of differentiated thyroid cancer. Methods A total of 60 patients with differentiated thyroid carcinoma treated in the First Hospital of Qinhuangdao City from January 2015 to January 2016 were prospectively randomly divided into study group( n = 30) and control group( n = 30). The control group was treated with levothyroxine sodium,and the study group was treated with iodine 131 on the basis of the control group. The clinical efficacy,thyroid function[thyroid stimulating antibody( TSAb),thyroid stimulating blocking antibody( TSBAb),thyroid stimulating hormone receptor antibody( TRAb) ],adverse reactions and follow-up after 5 years were observed and compared between the two groups to understand the recurrence and metastasis of the patients. Results The total effective rate in the study group was 90. 00%,which was significantly higher than that in the control group( 73. 33%),the difference was statistically significant( P < 0. 05). After treatment,the levels of TSAb,TSBAb,TRAb in the study group were( 2. 12 ± 0. 48) U/L,( 9. 88 ± 2. 06) U/mL,and( 7. 40 ± 1. 31) U/L,which were lower than those in the control group[( 3. 22 ± 0. 75) U/L,( 17. 11 ± 3. 48) U/m L,( 16. 80 ± 3. 11) U/L],the differences were statistically significant( P < 0. 05). The incidence of adverse reactions in the study group was 6. 67%,significantly lower than that in the control group( 13. 33%),the difference was statistically significant( P < 0. 05). After 5 years of follow-up,the recurrence rate,cervical lymph node metastasis rate,and distant metastasis rate in the study group were 6. 67%,10. 00% and 10. 00%,which were all lower than those in the control group( 23. 33%,30. 00% and 26. 67%),the differences were statistically significant( P < 0. 05). Conclusion Iodine 131 is better than levothyroxine sodium in the treatment of differentiated thyroid cancer. It can promote the recovery of thyroid function,reduce the incidence of adverse reactions,and effectively reduce the risk of postoperative recurrence and metastasis.更多还原