促甲状腺激素抑制疗法对分化型甲状腺癌患者骨代谢、CD44V6、sIL-2R水平的影响

Effect of TSH inhibition therapy on bone metabolism, CD44v6, and sIL-2R levels in patients with differentiated thyroid carcinoma

摘要:

目的 研究促甲状腺激素（TSH）抑制疗法对分化型甲状腺癌（DTC）患者骨代谢、白细胞分化抗原44变异型6（CD44V6）及可溶性白细胞介素-2受体（sIL-2R）水平的影响。方法 选取2019年3月—2022年1月内蒙古医科大学附属医院收治的100例DTC患者，按照随机数字表法分为对照组和TSH组，每组50例。对照组术后给予甲状腺素替代疗法，TSH组术后给予TSH抑制疗法。比较两组治疗前后甲状腺功能［TSH、游离三碘甲状腺原氨酸（FT₃）、游离甲状腺激素（FT₄）］、骨代谢［总I型胶原氨基酸延长肽（PINP）、β-胶原特殊序列（β-Crosslaps）］、免疫功能［T淋巴细胞亚群（CD3⁺、CD4⁺、CD8⁺）］、血清CD44V6、sIL-2R水平的变化情况，并评价两组用药的安全性。结果 治疗后3个月，TSH组血清TSH水平较对照组低（P <0.05），而血清FT₃、FT₄水平较对照组高（P <0.05）；两组治疗前后血清PINP、β-Crosslaps水平比较，差异无统计学意义（P >0.05）；治疗后3个月，TSH组CD3⁺、CD4⁺水平较对照组高（P <0.05），而CD8⁺水平较对照组低（P <0.05）；治疗后3个月，TSH组CD44V6、sIL-2R水平较对照组低（P <0.05）；两组不良反应发生率比较，差异无统计学意义（P >0.05）。结论 TSH抑制疗法可有效改善DTC患者甲状腺功能，增强免疫功能，降低血清CD44V6、sIL-2R水平，对骨代谢影响较小，且用药安全性良好。

Abstract:

Objective To study the effects of thyroid stimulating hormone (TSH) inhibition therapy on bone metabolism, leukocyte differentiation antigen 44 variant 6 (CD44v6), and soluble interleukin-2 receptor (sIL-2R) levels in patients with differentiated thyroid carcinoma (DTC).Methods From March 2019 to January 2022, 100 patients with DTC admitted to the Affiliated Hospital of Inner Mongolia Medical University were randomly divided into control group (50 cases, given thyroxine replacement therapy after operation) and TSH group (50 cases, given TSH inhibition therapy after operation). Thyroid function indexes [TSH, free triiodothyronine (FT₃), free thyroid hormone (FT₄)], bone metabolism indexes [total type I collagen amino acid prolongation peptide (PINP), β-collagen special sequence (β-Crosslaps)], immune function indexes [T lymphocyte subsets (CD3⁺, CD4⁺, CD8⁺)], serum CD44V6 and SIL-2R levels, and the safety were compared between the two groups before and after treatment.Results Three months after treatment, the serum TSH level in TSH group was lower than that in the control group (P < 0.05), while the serum FT₃ and FT₄ levels were higher than that in the control group (P < 0.05); There was no significant difference in the level of Serum PINP and β-Crosslaps (P > 0.05); Three months after treatment, the levels of CD3⁺ and CD4⁺ in TSH group were higher than those in the control group (P < 0.05), while the levels of CD8⁺ in TSH group were lower than those in the control group (P < 0.05); Three months after treatment, the levels of CD44V6 and sIL-2R in TSH group were lower than those in control group (P < 0.05); There was no significant difference in the incidence of adverse reactions between the two groups (P > 0.05).Conclusion TSH inhibition therapy can effectively improve thyroid function, enhance immune function, reduce serum CD44V6 and SIL-2R levels in patients with DTC, and has little effect on bone metabolism, with good drug safety.