中华核医学与分子影像杂志
中華覈醫學與分子影像雜誌
중화핵의학여분자영상잡지
Chinese Journal of Nuclear Medicine and Molecular Imaging
2012年
4期
265-268
,共4页
陈泽泉%陆汉魁%王阳%丁颖%辛丽君%陈立波%罗全勇%余永利
陳澤泉%陸漢魁%王暘%丁穎%辛麗君%陳立波%囉全勇%餘永利
진택천%륙한괴%왕양%정영%신려군%진립파%라전용%여영리
甲状腺肿瘤%放射疗法%碘放射性同位素%甲状旁腺
甲狀腺腫瘤%放射療法%碘放射性同位素%甲狀徬腺
갑상선종류%방사요법%전방사성동위소%갑상방선
Thyroid neoplasms%Radiotherapy%Iodine radioisotopes%Parathyroid glands
目的 探讨131I清除术后残留甲状腺组织(简称清甲)治疗对DTC患者在治疗后短期内甲状旁腺功能的影响.方法 DTC患者共73例,其中男15例,女58例,年龄20～70( 44.59±12.89)岁.分别于131I清甲治疗前1天及治疗后第5天检测患者血Ca2+及PTH水平,比较131I清甲前后患者的血清PTH变化.以性别、年龄及术后超声示甲状腺残留组织(简称残甲)情况分组,分析影响治疗后血清PTH下降的因素.使用SAS 8.0软件对治疗前后计量数据等行配对t检验及方差分析,对年龄组与残甲组间数据行x2检验.结果 131I清甲治疗前后所有患者血钙均在正常范围,均值分别为(2.24±0.93)和(2.23±0.84) mmol/L,差异无统计学意义(t=1.81,P＞0.05);治疗后DTC患者血清PTH为(27.19±11.58) ng/L,明显低于治疗前的(37.33±17.71)ng/L(t=6.76,P＜0.01),其中79.45％ (58/73)的患者PTH较治疗前下降,10.95％ (8/73) PTH值低于正常;但均未出现低钙血症.治疗前后不同性别组间血清PTH差异无统计学意义(t=1.06和1.83,P均＞0.05),但发生PTH降低例数比较有统计学意义(x2=4.37,P=0.036).不同年龄组及不同残甲组治疗前后血清PTH的变化差异均无统计学意义(F=0.58、0.61,0.46、0.76,P均＞0.05).结论 131I治疗可导致DTC患者短期内PTH水平降低,女性更为敏感,但一般不会引发低钙血症.这种变化与年龄及残甲组织多少无关.
目的 探討131I清除術後殘留甲狀腺組織(簡稱清甲)治療對DTC患者在治療後短期內甲狀徬腺功能的影響.方法 DTC患者共73例,其中男15例,女58例,年齡20～70( 44.59±12.89)歲.分彆于131I清甲治療前1天及治療後第5天檢測患者血Ca2+及PTH水平,比較131I清甲前後患者的血清PTH變化.以性彆、年齡及術後超聲示甲狀腺殘留組織(簡稱殘甲)情況分組,分析影響治療後血清PTH下降的因素.使用SAS 8.0軟件對治療前後計量數據等行配對t檢驗及方差分析,對年齡組與殘甲組間數據行x2檢驗.結果 131I清甲治療前後所有患者血鈣均在正常範圍,均值分彆為(2.24±0.93)和(2.23±0.84) mmol/L,差異無統計學意義(t=1.81,P＞0.05);治療後DTC患者血清PTH為(27.19±11.58) ng/L,明顯低于治療前的(37.33±17.71)ng/L(t=6.76,P＜0.01),其中79.45％ (58/73)的患者PTH較治療前下降,10.95％ (8/73) PTH值低于正常;但均未齣現低鈣血癥.治療前後不同性彆組間血清PTH差異無統計學意義(t=1.06和1.83,P均＞0.05),但髮生PTH降低例數比較有統計學意義(x2=4.37,P=0.036).不同年齡組及不同殘甲組治療前後血清PTH的變化差異均無統計學意義(F=0.58、0.61,0.46、0.76,P均＞0.05).結論 131I治療可導緻DTC患者短期內PTH水平降低,女性更為敏感,但一般不會引髮低鈣血癥.這種變化與年齡及殘甲組織多少無關.
목적 탐토131I청제술후잔류갑상선조직(간칭청갑)치료대DTC환자재치료후단기내갑상방선공능적영향.방법 DTC환자공73례,기중남15례,녀58례,년령20～70( 44.59±12.89)세.분별우131I청갑치료전1천급치료후제5천검측환자혈Ca2+급PTH수평,비교131I청갑전후환자적혈청PTH변화.이성별、년령급술후초성시갑상선잔류조직(간칭잔갑)정황분조,분석영향치료후혈청PTH하강적인소.사용SAS 8.0연건대치료전후계량수거등행배대t검험급방차분석,대년령조여잔갑조간수거행x2검험.결과 131I청갑치료전후소유환자혈개균재정상범위,균치분별위(2.24±0.93)화(2.23±0.84) mmol/L,차이무통계학의의(t=1.81,P＞0.05);치료후DTC환자혈청PTH위(27.19±11.58) ng/L,명현저우치료전적(37.33±17.71)ng/L(t=6.76,P＜0.01),기중79.45％ (58/73)적환자PTH교치료전하강,10.95％ (8/73) PTH치저우정상;단균미출현저개혈증.치료전후불동성별조간혈청PTH차이무통계학의의(t=1.06화1.83,P균＞0.05),단발생PTH강저례수비교유통계학의의(x2=4.37,P=0.036).불동년령조급불동잔갑조치료전후혈청PTH적변화차이균무통계학의의(F=0.58、0.61,0.46、0.76,P균＞0.05).결론 131I치료가도치DTC환자단기내PTH수평강저,녀성경위민감,단일반불회인발저개혈증.저충변화여년령급잔갑조직다소무관.
Objective To investigate the short-term effect on parathyroid function after 131I treatment for DTC.Methods Seventy-three patients ( 15 males,58 females,mean age (44.59 ± 12.89) y) who underwent 131I treatment for thyroid remnant ablation were enrolled in the study.Serum PTH and Ca2+levels were evaluated at baseline and at 5 d after 131I administration.PTH levels were compared based on gender,age and residual thyroid mass.The t-test,analysis of variance and x2 test were used for statistical analysis.Results Fifty-eight patients showed decreased PTH (79.45％),and 8 patients ( 10.95％ ) were below normal levels.Serum PTH levels significantly decreased at 5 d from baseline at (37.33 ± 17.71 ) ng/L to ( 27.19 ± 11.58 ) ng/L,respectively ( t =6.76,P ＜ 0.01 ),but serum Ca2+ levels were within the normal range.There were statistically significant differences between gender (x2 =4.37,P =0.036),but no differences in age and quantity of residual thyroid mass ( F =0.58,0.61,0.46,0.76,all P ＞ 0.05 ).Conclusions 131I treatment for DTC may induce decreased PTH levels in the short-term,particularly for female patients ; though,serum Ca2 + concentration shows no statistically significant decrease.These changes are irrelevant to age and quantity of residual thyroid mass.
