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在分化甲状腺癌的甲状腺切除术后三年内源性正常甲状腺功能的患病率
Tina Toft Kristensen1, Christina Caroline Plaschke1,2, Anne Fog Lomholt1,2
1Department of Otorhinolaryngology Head and Neck Surgery and Audiology, Copenhagen University Hospital, Rigshospitalet. Inge Lehmanns Vej 8, 2100 Copenhagen, Denmark.
European thyroid journal
|August 21, 2025
概括
对于分化甲状腺癌的甲状腺刺激激素 (TSH) 水平稍微升高至4mIU/ L后,意味着三分之一的患者可能需要在三年内接受levothyroxine治疗. 在不需要药物治疗的患者中,这种方法可能会显著增加TSH.
科学领域:
- 内分泌学
- 癌症学
背景情况:
- 差异化甲状腺癌 (DTC) 的治疗通常涉及甲状腺切除术.
- 手术后的治疗策略旨在维持甲状腺功能并防止复发.
研究的目的:
- 在甲状腺切除术后三年,以确定低风险DTC的正常内源性甲状腺功能.
- 评估接受术后甲状腺刺激激素 (TSH) 水平高达4mIU/ L对莱沃西替代疗法的影响.
主要方法:
- 对162名丹麦东部患者进行了回顾.
- 如果手术后TSH低于4mIU/ l,则没有使用levothyroxine的患者进行跟踪.
- 收集的数据包括左甲状腺素的发作,TSH水平,复发和残留叶结节性.
主要成果:
- 88% 的患者在手术前不需要使用激素.
- 甲状腺内生正常功能在甲状腺切除术后的一年后从80%降低到66%.
- 在34%的患者中,三年后出现甲状腺功能低下 (TSH>4. 0毫克单位/升),需要接受levothyroxine治疗.
- 在未接受levothyroxine治疗的患者中,TSH水平在三年内显著增加到正常范围内 (p< 0. 0001).
- 没有观察到复发;由于结节的生长,3%的患者接受了完整的甲状腺切除术.
结论:
- 大约三分之一的DTC患者需要在甲状腺切除术后三年内接受4mIU/ L的TSH值治疗.
- 在这种群体中,避免使用levothyroxine治疗会导致TSH水平显著增加.
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