Objective:To study the effects of TSH inhibition after total thyroidectomy on Tg,VEGF,TSGF,CD44V6,sIL-2R and T lymphocyte subsets in patients with differentiated thyroid carcinoma (DTC).Methods:A total of 100 patients with DTCin our hospital from January 2014 to January 2017 were enrolled in this study.The subjects were divided into the control group (n =50) and the treatment group (n =50) randomly.The control group were treated with thyroid hormone replacement therapy,the treatment groupwere treated with levothyroxine sodium oral therapy,the two groups were treated for 1 week.The serum Tg,VEGF,TSGF,CD44V6,sIL-2R and peripheral blood CD3+,CD4+,CD8+ of the two groups before and after treatment were compared.Results:There were no significantly differences of the serum Tg,VEGF,TSGF,CD44V6,sIL-2Rof the two groups beforetreatment (P ＞ 0.05).The serum Tg,VEGF,TSGF,CD44V6,sIL-2Rof the two groups after treatment were significantly lower than before treatment (P＜0.05),and that of the treatment group after treatment were significantly lower than the control group (P＜0.05).There were no significantly differences of the peripheral blood CD3+,CD4+,CD8+ of the two groups beforetreatment (P＞0.05).The peripheral blood CD3+,CD4+ of the two groups after treatment were significantly higher than before treatment (P＜0.05),the peripheral blood CD8+ of the two groups after treatment were significantly lower than before treatment (P＜0.05),and that of the treatment group after treatment were significantly better than the control group (P＜0.05).Conclusion:TSH inhibition after total thyroidectomy for patients with DTC can reduce the serum Tg,VEGF,TSGF,CD44V6,sIL-2R levels,improve the cellular immunity function,and it was worthy clinical application.%目的:探讨促甲状腺激素(thyroid stimulating hormone,TSH)抑制疗法对分化型甲状腺癌(differentiated thyroid carcinoma,DTC)患者术后血清甲状腺球蛋白(thyroglobulin,Tg)、血管内皮生长因子(vascular endothelial growth factor,VEGF)、肿瘤特异性生长因子(tumors pecific growth factor,TSGF)、白细胞分化抗原44变异型6(CD44V6)、可溶性白细胞介素-2受体(soluble interleukin-2 receptor,sIL-2R)及T淋巴细胞亚群水平的影响.方法:选择2014年1月～2017年1月我院收治的接受甲状腺全切手术治疗的100例DTC患者,随机分为对照组和实验组,各50例.对照组患者常规给予甲状腺素替代治疗,实验组患者给予TSH抑制疗法(口服左甲状腺素钠片,控制血清TSH水平低于0.1mU/L),两组患者均给予治疗1个月.比较两组患者治疗前后血清Tg、VEGF、TSGF、CD44V6、sIL-2R水平及外周血CD3+、CD4+、CD8+水平.结果:两组治疗前的血清Tg、VEGF、TSGF、CD44V6、sIL-2R水平比较,均无显著性差异(P＞0.05);两组治疗后的血清Tg、VEGF、TSGF、CD44V6、sIL-2R水平相比治疗前均较低,且实验组治疗后血清Tg、VEGF、TSGF、CD44V6、sIL-2R水平变化均显著优于对照组(P＜0.05).两组治疗前的外周血CD3+、CD4+、CD8+水平比较,均无显著性差异(P＞0.05);两组治疗后的外周血CD3+、CD4+水平相比治疗前均较高、CD8+水平相比治疗前均较低,且实验组治疗后血外周血CD3+、CD4+、CD8+水平变化均优于对照组,具有显著性差异(P＜0.05).结论:DTC行甲状腺全切手术治疗后接受TSH抑制疗法能够有效降低血清Tg、VEGF、TSGF、CD44V6、sIL-2R水平,改善细胞免疫功能,值得在临床上推广应用.
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