鼻咽癌同步放化疗对患者甲状腺功能隐匿性损伤的研究

　　摘 要 目的：探討鼻咽癌同步放化疗（CCRT）患者甲状腺功能隐匿性损伤情况。方法：收集2015年1月至2017年1月收治的接受CCRT治疗的鼻咽癌患者53例，比较CCRT治疗前、治疗结束即刻和治疗结束后3个月患者甲状腺功能减退发生情况及甲状腺激素水平变化情况。结果：患者甲状腺功能减退发生率在CCRT治疗结束后3个月为13.21%（7/53），略高于治疗结束即刻的5.66%（3/53），但差异无统计学意义（P>0.05）。患者在CCRT前、治疗结束即刻和治疗结束后3个月的游离型三碘甲状腺原氨酸（FT3）分别为（4.90±0.62）pmol/L、（4.52±0.58）pmol/L和（4.20±0.52）pmol/L；游离型四碘原氨酸（FT4）水平分别为（15.37±2.47）pmol/L、（14.94±2.33）pmol/L和（13.85±2.16）pmol/L；促甲状腺激素水平（TSH）分别为（1.71±0.44）mU/L、（1.90±0.48）mU/L和（2.57±0.66）mU/L。CCRT治疗结束后3个月，患者FT3、FT4水平明显低于CCRT前，促甲状腺激素水平明显高于CCRT前，差异有统计学意义（P<0.05）。结论：CCRT后，随着时间延长，患者甲状腺激素水平异常越来越明显，甲状腺功能减退发生率逐渐升高，宜在3个月内进行复查，及早发现甲状腺功能减退。
　　关键词 鼻咽癌；同步放化疗；甲状腺功能隐匿性损伤
　　中图分类号：R739.63/R581 文献标志码：A 文章编号：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.

相关热词搜索：鼻咽癌 化疗 隐匿 损伤 患者