本文選題：甲狀腺癌 + 促甲狀腺素��； 參考：《吉林大學(xué)》2017年碩士論文

【摘要】：目的:對(duì)甲狀腺癌術(shù)后患者進(jìn)行隨訪,研究TSH抑制治療對(duì)患者體內(nèi)血脂水平的作用,同時(shí)研究性別、絕經(jīng)對(duì)該作用的影響,并探討TSH抑制治療背景下性別、絕經(jīng)與血脂的關(guān)系。方法:通過(guò)對(duì)2008-2011年于吉林大學(xué)中日聯(lián)誼醫(yī)院行甲狀腺癌根治術(shù)的患者進(jìn)行隨訪,獲得相關(guān)臨床數(shù)據(jù)。排除伴有影響血脂的全身系統(tǒng)性疾病者、服用影響血脂藥物者、長(zhǎng)期煙酒史者及因依從性問(wèn)題致數(shù)據(jù)獲取不全者,共納入145例患者的臨床數(shù)據(jù)進(jìn)行下一步研究。收集患者的相關(guān)信息,并測(cè)定甲狀腺功能、血脂水平,包括血清促甲狀腺激素(TSH)、游離三碘甲狀腺原氨酸(FT3)、游離甲狀腺素(FT4)、總膽固醇(TC)、甘油三酯(TG)、高密度脂蛋白膽固醇(HDL-C)、低密度脂蛋白膽固醇(LDL-C)。根據(jù)TSH抑制程度將患者分為TSH0.1m IU/L組、0.1m IU/L≤TSH0.372 m IU/L(TSH正常值下限)組、0.372 m IU/L≤TSH2.0m IU/L組和TSH≥2.0m IU/L組;根據(jù)術(shù)后TSH抑制治療時(shí)間將患者分為3年≤時(shí)間5年組和5年≤時(shí)間8年組;同時(shí)按照性別差異、是否絕經(jīng)也分別進(jìn)行了分類。運(yùn)用SPSS 19.0軟件進(jìn)行統(tǒng)計(jì)學(xué)分析,研究TSH抑制治療的程度和時(shí)間對(duì)血脂的作用及該作用的性別、絕經(jīng)差異,并探究TSH抑制治療背景下性別、絕經(jīng)和血脂的關(guān)系。結(jié)果:1.TSH抑制治療程度與血脂的關(guān)系:TSH與總膽固醇、LDL-C呈顯著正相關(guān);FT3與總膽固醇、LDL-C呈顯著負(fù)相關(guān);TSH≥2.0m IU/L組的LDL-C水平顯著高于0.372m IU/L≤TSH2.0m IU/L組;TSH、FT3與甘油三酯、HDL-C、LDL/HDL無(wú)顯著相關(guān);FT4與血脂譜無(wú)顯著相關(guān)。2.TSH抑制治療時(shí)間與血脂:TSH抑制治療時(shí)間與甘油三酯水平呈顯著正相關(guān);5年≤時(shí)間8年組的甘油三酯水平顯著高于3年≤時(shí)間5年組;TSH抑制治療時(shí)間與總膽固醇、HDL-C、LDL-C、LDL/HDL無(wú)顯著相關(guān)。3.女性患者TSH抑制治療的程度與總膽固醇、LDL-C水平存在顯著的負(fù)相關(guān),TSH抑制治療的時(shí)間與甘油三酯水平存在顯著的正相關(guān),以上兩種相關(guān)性在男性患者群中暫未發(fā)現(xiàn);絕經(jīng)女性患者TSH抑制治療的程度與總膽固醇、LDL-C水平存在顯著的負(fù)相關(guān),TSH抑制治療的時(shí)間與甘油三酯、LDL/HDL水平存在顯著的正相關(guān),以上兩種相關(guān)性在非絕經(jīng)患者群中并未發(fā)現(xiàn)。4.TSH抑制治療背景下性別、絕經(jīng)與血脂的關(guān)系:男性的甘油三酯、LDL/HDL水平顯著高于女性;女性的HDL-C水平顯著高于男性;總膽固醇水平、LDL-C水平未見(jiàn)明顯性別差異;TSH抑制治療背景下絕經(jīng)女性的總膽固醇、甘油三酯、HDL-C、LDL-C、LDL/HDL水平均顯著高于非絕經(jīng)女性。結(jié)論:1.甲狀腺癌術(shù)后TSH抑制治療利于總膽固醇、LDL-C水平的改善,該作用在TSH值=2m IU/L的節(jié)點(diǎn)前后表現(xiàn)更為明顯;2.甲狀腺癌術(shù)后TSH抑制治療時(shí)間對(duì)甘油三酯水平存在影響;3.TSH抑制治療對(duì)女性患者血脂水平的影響較男性患者更為明顯;TSH抑制治療對(duì)絕經(jīng)女性患者血脂水平的影響較非絕經(jīng)女性患者更為明顯;4.在TSH抑制治療背景下,性別、絕經(jīng)因素對(duì)血脂水平存在影響。
[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.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R736.1

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