分化型甲状腺癌术后131I治疗及诊断性显像前提高TSH水平的方案及其影响

Methods for improving TSH level and their effect in postoperative patients with differentiated thyroid cancer

  • 摘要: 分化型甲状腺癌(DTC)术后131I治疗及诊断性显像前较高水平的促甲状腺激素(TSH)能增强131I疗效和提高显像灵敏度。提高TSH的方案主要包括甲状腺激素撤退(THW)及重组人TSH,但THW引起的急性甲状腺功能减退将导致血脂代谢异常、肾功能受损、心血管疾病和神经精神疾病,对患者的生活质量造成显著影响。笔者就目前应用于临床的两种提高TSH的方案及其对DTC患者临床和生活质量的影响进行综述。

     

    Abstract: A high level of thyroid stimulating hormone (TSH) is required to stimulate sufficient radioiodine uptake for diagnostic imaging or therapy. The current methods for improving TSH level include thyroid hormone withdrawal and recombinant human TSH. However, acute hypothyroidism caused by thyroid hormone withdrawal (THW) before radioactive iodine remnant ablation/treatment or diagnostic scanning significantly influences lipid metabolism, renal function, cardiovascular and neuropsychiatric diseases, and quality of life. This review aimed to summarize these methods and their effect on the clinical and quality of life in patients with differentiated thyroid cancer.

     

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