CAJ | 학술논문

目的探讨分化型甲状腺癌患者术后个体化促甲状腺激素(TSH)抑制治疗的作用和意义.方法回顾性分析我科556例分化型甲状腺癌甲状腺全切或次全切除术后行TSH抑制治疗患者的临床资料.患者分为两组:A组(304例):未进行双风险评估直接行术后TSH抑制治疗;B组(252例):按照分化型甲状腺癌的复发危险度分层条件和TSH抑制治疗的不良反应风险分层条件进行风险评估,按照双风险评估的结果制定DTC术后TSH抑制治疗目标.结果 A组患者3年内的无复发和转移率为96.8％;B组患者3年内的无复发和转移率为99.2％.B组3年无复发和转移率明显高于A组(P=0.044).B组患者的心血管及其他疾病相关事件的住院率较A组患者降低了89％.结论个体化TSH抑制治疗方法不仅能显著降低分化型甲状腺癌复发率和转移率,还能明显减少外源性亚临床甲状腺功能亢进导致的心血管疾病及其他疾病相关事件的门诊就诊率、住院率.
목적 탐토분화형갑상선암환자술후개체화촉갑상선격소(TSH)억제치료적작용화의의.방법 회고성분석아과556례분화형갑상선암갑상선전절혹차전절제술후행TSH억제치료환자적림상자료.환자분위량조:A조(304례):미진행쌍풍험평고직접행술후TSH억제치료;B조(252례):안조분화형갑상선암적복발위험도분층조건화TSH억제치료적불량반응풍험분층조건진행풍험평고,안조쌍풍험평고적결과제정DTC술후TSH억제치료목표.결과 A조환자3년내적무복발화전이솔위96.8％;B조환자3년내적무복발화전이솔위99.2％.B조3년무복발화전이솔명현고우A조(P=0.044).B조환자적심혈관급기타질병상관사건적주원솔교A조환자강저료89％.결론 개체화TSH억제치료방법불부능현저강저분화형갑상선암복발솔화전이솔,환능명현감소외원성아림상갑상선공능항진도치적심혈관질병급기타질병상관사건적문진취진솔、주원솔.
Objective To investigate the value of individualized thyroid stimulating hormone (TSH) inhibition therapy in postoperative patients with differentiated thyroid carcinoma.Methods The medical record and follow-up data of the 556 patients with differentiated thyroid carcinoma after total or neartotal thyroidectomy were retrospectively reviewed.Patients were divided into two groups:Group A (304 cases) received TSH suppression therapy without risk assessment.Group B (252 cases) were given TSH suppression therapy in accord with risk assessment of both differentiated thyroid cancer recurrence risk stratification condition and the side effects of TSH suppression therapy risk stratification.Results The 3-year non-recurrence and (or) non-metastasis rate in group B was 99.2％ which was higher than 96.8％ in group A (P =0.044).The hospitalization rate caused by postoperative cardiovascular events or other morbidities in group B decreased 89％ than that in group A.Conclusions Individualized TSH suppression therapy can significantly decrease the recurrence and metastasis rate as well as concurrent morbidities caused by unnecessary TSH inhibition.