鼻咽癌同步放化療對(duì)患者甲狀腺功能隱匿性損傷的研究

　　摘 要 目的：探討鼻咽癌同步放化療（CCRT）患者甲狀腺功能隱匿性損傷情況。方法：收集2015年1月至2017年1月收治的接受CCRT治療的鼻咽癌患者53例，比較CCRT治療前、治療結(jié)束即刻和治療結(jié)束后3個(gè)月患者甲狀腺功能減退發(fā)生情況及甲狀腺激素水平變化情況。結(jié)果：患者甲狀腺功能減退發(fā)生率在CCRT治療結(jié)束后3個(gè)月為13.21%（7/53），略高于治療結(jié)束即刻的5.66%（3/53），但差異無(wú)統(tǒng)計(jì)學(xué)意義（P>0.05）�；颊咴贑CRT前、治療結(jié)束即刻和治療結(jié)束后3個(gè)月的游離型三碘甲狀腺原氨酸（FT3）分別為（4.90±0.62）pmol/L、（4.52±0.58）pmol/L和（4.20±0.52）pmol/L；游離型四碘原氨酸（FT4）水平分別為（15.37±2.47）pmol/L、（14.94±2.33）pmol/L和（13.85±2.16）pmol/L；促甲狀腺激素水平（TSH）分別為（1.71±0.44）mU/L、（1.90±0.48）mU/L和（2.57±0.66）mU/L。CCRT治療結(jié)束后3個(gè)月，患者FT3、FT4水平明顯低于CCRT前，促甲狀腺激素水平明顯高于CCRT前，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論：CCRT后，隨著時(shí)間延長(zhǎng)，患者甲狀腺激素水平異常越來(lái)越明顯，甲狀腺功能減退發(fā)生率逐漸升高，宜在3個(gè)月內(nèi)進(jìn)行復(fù)查，及早發(fā)現(xiàn)甲狀腺功能減退。
　　關(guān)鍵詞 鼻咽癌；同步放化療；甲狀腺功能隱匿性損傷
　　中圖分類號(hào)：R739.63/R581 文獻(xiàn)標(biāo)志碼：A 文章編號(hào)：1006-1533（2018）04-0021-03
　　Study on occult injury of thyroid function in nasopharyngeal carcinoma patients treated with concurrent chemoradiotherapy
　　TAN Hongwen， XIE Qinglan， WANG Xiaohui， LI Caihua， ZHU Tong， LIU Jing， WANG Hailan， LIAO Qingping（Oncology Department of Central People’s Hospital of Jian， Jian 343000， Jiangxi Province， China）
　　ABSTRACT Objective： To investigate the occult injury of thyroid function in patients with nasopharyngeal carcinoma treated with concurrent chemoradiotherapy（CCRT）. Methods： The incidence of hypothyroidism and thyroid hormone levels before treatment， at the end of treatment and 3 months after treatment in 53 patients with nasopharyngeal carcinoma who received CCRT treatment from January 2015 to January 2017 were compared. Results： The incidence of hypothyroidism was 13.21%（7/53） in 3 months after CCRT treatment， which was slightly higher than 5.66%（3/53） at the end of treatment， but the difference was not statistically significant（P>0.05）. The FT3 levels of patients before CCRT， at the end of treatment and 3 months after treatment were （4.90±0.62） pmol/L， （4.52±0.58） pmol/L and （4.20±0.52） pmol/L， respectively. The levels of FT4 were （15.37±2.47） pmol/L， （14.94±2.33） pmol/L and （13.85±2.16） pmol/L， respectively. The levels of thyroid stimulating hormone（TSH） were （1.71±0.44） mU/L， （1.90±0.48） mU/L and （2.57±0.66） mU/L， respectively. After 3 months of CCRT treatment， the levels of FT3 and FT4 were significantly lower than those before CCRT. The level of thyroid stimulating hormone was significantly higher than that before CCRT， and the difference was statistically significant（P<0.05）. Conclusion： With the prolongation of time after CCRT， the abnormal levels of thyroid hormone are more and more obvious in patients. The incidence of hypothyroidism is gradually increasing. It should be reexamined within 3 months， and hypothyroidism can be detected early.

相關(guān)熱詞搜索：鼻咽癌 化療 隱匿 損傷 患者