关键词: 甲状腺癌, 左旋甲状腺素, 不同剂量, 抑制治疗, 骨代谢, 糖脂代谢

Abstract: ［Abstract］ Objective To study the effects of different doses of levothyroxine （LT4） suppressive therapy on glucolipid metabolism and bone metabolism after radical resection of differentiated thyroid carcinoma （DTC）. Methods Eighty patients with DTC radical resection in our hospital from April 2017 to April 2018 were randomly divided into two groups with 40 cases in each group. 131I was used to clear residual thyroid tissues at 1 month after DTC radical resection and LT4 suppressive therapy was given to patients， and the dose was 2.5 μg/kg in load group and 2.0 μg/kg in routine group， and the course of treatment was 6 months. The changes of thyroid function， glucolipid metabolism， bone metabolism and bone mineral density were compared between the two groups before and after treatment. Results After treatment， the levels of serum FT3 and FT4 were significantly increased （P<0.05） while the serum TSH level was significantly decreased （P<0.05）， and the levels of serum FT3 and FT4 in load group were higher than those in routine group while the serum TSH level was lower than that in routine group （P<0.05）. The levels of FBG， HbA1c and serum TC， TG and LDL?C in the two groups were significantly decreased （P<0.05）， and the levels of FBG， HbA1c and serum TC， TG and LDL?C in load group were lower than those in routine group （P<0.05）. The levels of serum BGP， BALP and ICTP were significantly increased in the two groups （P<0.05）， and the levels of serum BGP， BALP and ICTP in load group were higher than those in routine group （P<0.05）. The BMD values of lumbar vertebrae L2~4， femoral neck and Ward’ s triangle were significantly decreased （P<0.05）， and there were no significant differences between the two groups （P>0.05）. Conclusions LT4 suppressive therapy after DTC radical resection can promote glucolipid metabolism and bone metabolism. The decrease of blood glucose and blood lipids levels in patients will increase with the increase of dose. And there is no obvious relationship between the decrease of bone mineral density and the dose in the short term.

Key words: thyroid cancer, glucolipid metabolism, bone metabolism, levothyroxine, different doses, suppressive therapy