卵巢恶性肿瘤综合治疗后性激素、甲状腺功能及骨密度变化的初步研究

发布时间：2018-04-04 07:06

本文选题：卵巢上皮性恶性肿瘤　切入点：性激素　出处：《青海大学》2017年硕士论文

【摘要】：目的:研究卵巢上皮性恶性肿瘤术前、术后化疗后女性性激素、甲状腺功能及骨密度变化,寻找以上数据发生变化的轨迹,进而为这些患者术后使用激素替代治疗提供临床依据。方法:选取2014年-2016年青海大学附属医院卵巢上皮性恶性肿瘤行全面分期手术或肿瘤细胞减灭术的患者,排除骨折、肝、肾、心脏等疾患;排除肿瘤细胞减灭术未将双侧卵巢完全切除的患者。年龄40-50岁且术前月经周期无明显异常;体重指数(20.16±1.08);术后正规补充化疗方案的32例,记录综合治疗前、综合治疗后1、2、3、6、12个月患者性激素水平、甲状腺功能及骨密度变化的原始数据,绘制变化曲线图,采用统计学方法整理并分析资料,得出结论。结果:综合治疗后1月E2较综合治疗前下降明显,综合治疗后1~2月E2轻度下降,综合治疗后2~12月E2维持在较低水平;综合治疗后1月FSH、LH较综合治疗前明显上升,综合治疗1月后轻度上升并维持较高水平至综合治疗后12月。综合治疗后1月PRL出现明显升高,综合治疗后2月持续升高,但升高幅度不如综合治疗后1月,综合治疗后3月、6月PRL下降,但仍然高于术前(正常参考值范围),综合治疗后12月PRL仍呈下降趋势,虽高于综合治疗前,但已经恢复至正常参考值范围较高值。综合治疗后Prog处于较低水平。综合治疗后1月T明显下降,综合治疗后1~12月T维持在较低水平。综合治疗后1~3月TSH较综合治疗前持续上升,综合治疗后3~6月开始下降但仍高于综合治疗前,综合治疗后6~12月继续下降至正常参考值范围。FT3、FT4、TT3、TT4、TPO-Ab综合治疗前后无明显变化。综合治疗前后BMD持续下降,治疗后12月与治疗前变化明显,出现轻度骨量减少。结论:卵巢上皮性恶性肿瘤综合治疗后性激素受到抑制;甲状腺功能减弱,随着时间的延长功能逐渐恢复;BMD持续下降,轻度骨量减少。患者术后可尽早给予激素替代治疗,缓解绝经综合症。
[Abstract]:Objective: to study the changes of sex hormone, thyroid function and bone mineral density (BMD) in women with ovarian epithelial neoplasms before and after chemotherapy.It provides clinical basis for these patients to use hormone replacement therapy after operation.Methods: the patients with ovarian epithelial malignant tumor in Qinghai University affiliated Hospital from 2014 to 2016 were selected to undergo comprehensive staging operation or tumor cell reduction operation, and to exclude fracture, liver, kidney, heart and other diseases.Patients whose bilateral ovaries were not completely removed without tumor cell reduction.Age 40-50 years and no significant abnormal menstrual cycle before operation; body mass index (BMI) was 20.16 卤1.08; 32 cases of postoperative regular supplementary chemotherapy regimen were recorded the original data of sex hormone level, thyroid function and bone mineral density before and after comprehensive therapy.Draw the curve of change, use statistical method to sort out and analyze the data, draw a conclusion.Results: the level of E2 decreased significantly in 1 month after comprehensive treatment, decreased slightly in 1 ~ 2 months after comprehensive treatment, maintained at a lower level in 2 ~ 12 months after comprehensive treatment, and increased significantly in 1 month after comprehensive treatment.After 1 month of combined therapy, the level increased slightly and maintained a high level until 12 months after combined therapy.PRL increased significantly in 1 month after comprehensive treatment, and continued to increase in 2 months after comprehensive treatment, but the increase was not as great as that after comprehensive treatment, and PRL decreased in 3 months and 6 months after comprehensive treatment.But it was still higher than before (normal reference value range), PRL still showed a downward trend in 12 months after comprehensive treatment, although it was higher than before, but had recovered to normal reference value range higher.After comprehensive treatment, Prog was at a low level.T decreased significantly in 1 month after comprehensive treatment, and remained at a low level from 1 to 12 months after comprehensive treatment.TSH continued to rise from 1 to 3 months after comprehensive treatment, but it began to decrease from 3 to 6 months after comprehensive treatment, but it was still higher than that before and after comprehensive treatment. After 6 ~ 12 months of comprehensive treatment, it continued to decrease to the normal reference range. FT3T3 / FT4TPO-Ab did not change significantly before and after combined treatment.BMD continued to decrease before and after comprehensive treatment, and the changes were obvious at 12 months after treatment and before treatment, with slight decrease in bone mass.Conclusion: after comprehensive treatment of ovarian epithelial malignant tumor, sex hormone is inhibited, thyroid function is weakened, and the function of BMD gradually recovers with time.Patients can be treated with hormone replacement therapy as soon as possible to relieve menopausal syndrome.
【学位授予单位】：青海大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R737.31

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