甲状腺癌术后TSH抑制治疗对血脂水平的影响

发布时间：2018-06-16 11:59

本文选题：甲状腺癌 + 促甲状腺素　；参考：《吉林大学》2017年硕士论文

【摘要】：目的:对甲状腺癌术后患者进行随访,研究TSH抑制治疗对患者体内血脂水平的作用,同时研究性别、绝经对该作用的影响,并探讨TSH抑制治疗背景下性别、绝经与血脂的关系。方法:通过对2008-2011年于吉林大学中日联谊医院行甲状腺癌根治术的患者进行随访,获得相关临床数据。排除伴有影响血脂的全身系统性疾病者、服用影响血脂药物者、长期烟酒史者及因依从性问题致数据获取不全者,共纳入145例患者的临床数据进行下一步研究。收集患者的相关信息,并测定甲状腺功能、血脂水平,包括血清促甲状腺激素(TSH)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)。根据TSH抑制程度将患者分为TSH0.1m IU/L组、0.1m IU/L≤TSH0.372 m IU/L(TSH正常值下限)组、0.372 m IU/L≤TSH2.0m IU/L组和TSH≥2.0m IU/L组;根据术后TSH抑制治疗时间将患者分为3年≤时间5年组和5年≤时间8年组;同时按照性别差异、是否绝经也分别进行了分类。运用SPSS 19.0软件进行统计学分析,研究TSH抑制治疗的程度和时间对血脂的作用及该作用的性别、绝经差异,并探究TSH抑制治疗背景下性别、绝经和血脂的关系。结果:1.TSH抑制治疗程度与血脂的关系:TSH与总胆固醇、LDL-C呈显著正相关;FT3与总胆固醇、LDL-C呈显著负相关;TSH≥2.0m IU/L组的LDL-C水平显著高于0.372m IU/L≤TSH2.0m IU/L组;TSH、FT3与甘油三酯、HDL-C、LDL/HDL无显著相关;FT4与血脂谱无显著相关。2.TSH抑制治疗时间与血脂:TSH抑制治疗时间与甘油三酯水平呈显著正相关;5年≤时间8年组的甘油三酯水平显著高于3年≤时间5年组;TSH抑制治疗时间与总胆固醇、HDL-C、LDL-C、LDL/HDL无显著相关。3.女性患者TSH抑制治疗的程度与总胆固醇、LDL-C水平存在显著的负相关,TSH抑制治疗的时间与甘油三酯水平存在显著的正相关,以上两种相关性在男性患者群中暂未发现;绝经女性患者TSH抑制治疗的程度与总胆固醇、LDL-C水平存在显著的负相关,TSH抑制治疗的时间与甘油三酯、LDL/HDL水平存在显著的正相关,以上两种相关性在非绝经患者群中并未发现。4.TSH抑制治疗背景下性别、绝经与血脂的关系:男性的甘油三酯、LDL/HDL水平显著高于女性;女性的HDL-C水平显著高于男性;总胆固醇水平、LDL-C水平未见明显性别差异;TSH抑制治疗背景下绝经女性的总胆固醇、甘油三酯、HDL-C、LDL-C、LDL/HDL水平均显著高于非绝经女性。结论:1.甲状腺癌术后TSH抑制治疗利于总胆固醇、LDL-C水平的改善,该作用在TSH值=2m IU/L的节点前后表现更为明显;2.甲状腺癌术后TSH抑制治疗时间对甘油三酯水平存在影响;3.TSH抑制治疗对女性患者血脂水平的影响较男性患者更为明显;TSH抑制治疗对绝经女性患者血脂水平的影响较非绝经女性患者更为明显;4.在TSH抑制治疗背景下,性别、绝经因素对血脂水平存在影响。
[Abstract]:Objective: to follow up the follow-up of postoperative patients with thyroid cancer to study the effect of TSH inhibition therapy on the blood lipid level in the patients, and to study the effect of sex and menopause on this effect, and to explore the relationship between sex, menopause and blood lipid under the background of TSH inhibition. Methods: through 2008-2011 years in Jilin University Sino Japanese Friendship Hospital, the radical thyroidectomy was carried out. The patients were followed up to obtain relevant clinical data. Excluding those with systemic systemic diseases associated with blood lipids, people who took blood lipid drugs, long term tobacco and alcohol history and data acquisition due to compliance problems, the clinical data of 145 patients were included in the next step. The information of the patients was collected and the thyroid was measured. Function, blood lipid levels, including serum thyrotropin hormone (TSH), free three iodine thyroxine (FT3), free thyroxine (FT4), total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), and low density lipoprotein cholesterol (LDL-C). The patients were divided into TSH0.1m IU/L group according to the degree of TSH inhibition. 0.1M IU/L was less than TSH (TSH normal lower limit) group, 0.372 m IU/L < TSH2.0m IU/L group and TSH > 2.0m IU/L group. According to the postoperative TSH inhibition treatment time, the patients were divided into 3 years 5 years group and 5 years less than 8 years group; at the same time, according to gender differences, the menopause was also classified. Statistical analysis was carried out with SPSS 19 software to study TSH inhibition treatment. The effect of degree and time on blood lipid and the sex and menopause difference of this effect, and to explore the relationship between sex, menopause and blood lipid under the background of TSH inhibition. Results: the relationship between the degree of 1.TSH inhibition and the blood lipid: TSH was positively correlated with total cholesterol and LDL-C; FT3 was negatively correlated with total cholesterol and LDL-C; LDL-C water in TSH > 2.0m IU/L group. The level was significantly higher than that of 0.372m IU/L < TSH2.0m IU/L group; TSH, FT3 had no significant correlation with triglyceride, HDL-C, LDL/HDL; FT4 and blood lipid spectrum had no significant correlation with.2.TSH inhibition time and blood lipid: TSH inhibition treatment time was positively correlated with triglyceride level; the level of triglycerides in 5 years less than 8 years was significantly higher than that of 3 years less than 5 years. There was no significant correlation between the degree of TSH inhibition in.3. female patients with total cholesterol, HDL-C, LDL-C, and LDL/HDL, and there was a significant negative correlation between the level of total cholesterol and LDL-C. There was a significant positive correlation between the time of TSH inhibition and the level of triglycerides. The above two correlations were not found in the male patients; menopause women suffered from the disease. There was a significant negative correlation between the degree of TSH inhibition and the level of total cholesterol and LDL-C. There was a significant positive correlation between the time of TSH inhibition and the level of triglyceride and LDL/HDL. The two correlations in the non menopause patients were not found in the background of.4.TSH inhibition, and the relationship between menopause and blood lipid: triglyceride and LDL/ in men. The level of HDL was significantly higher than that of women; the level of HDL-C in women was significantly higher than that in men; there was no significant gender difference in total cholesterol level and LDL-C level. The levels of total cholesterol, triglycerides, HDL-C, LDL-C and LDL/HDL in postmenopausal women with TSH inhibition were significantly higher than those of non menopause women. Conclusion: 1. after the operation of thyroid cancer, TSH inhibition is beneficial to the total gallbladder. The improvement of sterol and LDL-C level was more obvious before and after the node of TSH value =2m IU/L; 2. the time of TSH inhibition after thyroid carcinoma had an effect on triglyceride level; the effect of 3.TSH inhibition therapy on the level of blood lipid in female patients was more obvious than that of male patients; the effect of TSH inhibition therapy on blood lipid levels in menopausal women patients was compared. Noise was more pronounced than non menopausal women; 4. in the context of TSH suppression treatment, gender and menopausal factors had an effect on blood lipid levels.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R736.1

【相似文献】