I131联合TSH抑制治疗对术后中高危组甲状腺乳头状癌患者心肌纤维化及心房颤动的影响

doi:10.3969/j.issn.1000-8535.2021.04.009

广州医药 ›› 2021, Vol. 52 ›› Issue (4): 40-44.DOI: 10.3969/j.issn.1000-8535.2021.04.009

I¹³¹联合TSH抑制治疗对术后中高危组甲状腺乳头状癌患者心肌纤维化及心房颤动的影响

汪秀衡¹, 刘克皝², 刘垚³, 胡恒境³

1 南华大学附属第一医院核医学科(衡阳 421000)
2 中南大学湘雅医院核医学科(长沙 410000)
3 南华大学附属第一医院心内科(衡阳421000)

出版日期:2021-07-20 发布日期:2021-11-23
通讯作者: 胡恒境,E-mail:bestmanhhj@hotmail.com
基金资助:
国家自然科学基金(81700306);湖南省自然科学基金(2018JJ3469);湖南省卫生健康委(C2019115)

Impact of I¹³¹ combined with thyroid-stimulating hormone for suppressive treatment on myocardial fibrosis and atrial fibrillation in patients with papillary thyroid

WANG Xiuheng¹, LIU Kehuang², LIU Yao³, HU Hengjing³

1 Department of Nuclear Medicine Lab, First Affiliated Hospital of University of South China, Hengyang 421001, China
2 Department of Nuclear Medicine Lab, Xiangya Hospital of Centre-south University, Changsha 410000, China
3 Department of Cardiology Lab, First Affiliated Hospital of University of South China, Hengyang 421000, China

Online:2021-07-20 Published:2021-11-23

摘要/Abstract

摘要： 目的探讨I¹³¹联合促甲状腺激素(TSH)抑制治疗对术后中高危组甲状腺乳头状癌(PTC)患者心肌纤维化及心房颤动(AF)的影响。方法选取2016年8月—2017年8月南华大学附属第一医院收治的因PTC行甲状腺双侧腺叶全切术或近全切除术患者69例,根据复发危险度分层分为中危组(49例)和高危组(20例), 两组患者均行I¹³¹ 联合TSH抑制治疗,治疗后嘱患者3个月进行1次复诊或自觉不适及时复诊,观察患者心血管系统症状、心房颤动及心肌纤维化发生情况,患者治疗前后可溶性基质溶素-2(sST2)、生长分化因子-15(GDF-15)、半乳糖凝集素-3 (GAL-3)及血清乳酸脱氢酶(LDHA)含量变化。结果 I¹³¹联合TSH抑制治疗后患者心房颤动发生率和心肌纤维化相关指标水平明显高于治疗前,且高危组患者治疗后心房颤动发生率和心肌纤维化相关指标水平高于中危组,差异均有统计学意义(P<0.05)。结论 I¹³¹联合TSH抑制治疗会增加PTC患者心肌纤维化和心房颤动的发生概率,且高危组PTC患者心肌纤维化和房颤的发生率高于中危组。

关键词: 甲状腺乳头状癌, 促甲状腺激素, I¹³¹, 心肌纤维化, 心房颤动

Abstract: Objective To investigate the impact of I¹³¹ combined with thyroid-stimulating hormone(TSH) for suppressive treatment on myocardial fibrosis(MF) and atrial fibrillation(AF) in patients with papillary thyroid (PTC). Methods 69 patients with PTC undergoing total or subtotal thyroidectomy admitted into First Affiliated Hospital of University of South China from Aug. 2016 to Aug. 2017 were selected and divided into middle-risk group (49 cases) and high-risk group (20 cases) according to the recurrence risk stratification. Two groups of patients were given I¹³¹ combined with thyroid-stimulating hormone for suppressive treatment. The patients were instructed to undergo a follow-up visit every 3 months after treatment or whenever felt unwell. The incidences of cardiovascular system symptoms, atrial fibrillation and myocardial fibrosis, changes of contents of serum soluble ST2 (sST2), growth differentiation factor-15 (GDF-15), galectin-3 (GAL-3) and lactate dehydrogenase A (LDHA) were observed. Results After I¹³¹ combined with thyroid-stimulating hormone suppressive treatment, the incidences of atrial fibrillation and myocardial fibrosis after treatment were higher than that before treatment, and the incidences of atrial fibrillation and myocardial fibrosis of high-risk group were higher than those of the middle-risk group, with statistically significant differences (P＜0.05). Conclusion Combined use of I¹³¹ and thyroid-stimulating hormone for suppressive treatment can increase the incidences of atrial fibrillation and ventricular remodeling of patients with PTC, and the incidences of high-risk group were higher than those of the middle-risk group.

Key words: Papillary thyroid, Thyroid-stimulating hormone, I¹³¹, Myocardial fibrosis, Atrial fibrillation

汪秀衡, 刘克皝, 刘垚, 胡恒境. I¹³¹联合TSH抑制治疗对术后中高危组甲状腺乳头状癌患者心肌纤维化及心房颤动的影响[J]. 广州医药, 2021, 52(4): 40-44.

WANG Xiuheng, LIU Kehuang, LIU Yao, HU Hengjing. Impact of I¹³¹ combined with thyroid-stimulating hormone for suppressive treatment on myocardial fibrosis and atrial fibrillation in patients with papillary thyroid[J]. Guangzhou Medical Journal, 2021, 52(4): 40-44.

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I¹³¹联合TSH抑制治疗对术后中高危组甲状腺乳头状癌患者心肌纤维化及心房颤动的影响

Impact of I¹³¹ combined with thyroid-stimulating hormone for suppressive treatment on myocardial fibrosis and atrial fibrillation in patients with papillary thyroid

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