左旋甲状腺素在预防结节性甲状腺肿术后复发的研究

摘要

研究左旋甲状腺素（ L-T4）在预防结节性甲状腺肿术后复发的作用。方法：结节性甲状腺肿术后分服药组（口服L-T4）和未服药组，经3-7年随访，使用B超、CT等检查手段，分析口服L-T4及持续服药时间与术后复发的关系。结果：本研究1161例患者中术后复发率为9．24％，未服药的患者术后复发率（22．09％）明显高于服药患者（5．37％），差异有统计学意义（P＜0．05）；服药1年以内的患者复发率明显高于服药1-2年的患者（P＜0．05），服药1-2年与服药2-3年，服药2-3年与服药3年以上的患者术后复发率无统计学差异（ P＞0．05）；服药患者中S-TSH≥3．6uTU/mL的患者复发率较S-TSH＜0．4及0．4≤S-TSH＜3．6的患者均显著升高（ P＜0．05）。结论：结节性甲状腺肿术后服用左旋甲状腺素片1-2年且将S-TSH控制在3．6uTU/mL对降低患者术后复发率有利。%To study the role of L-T4 in the prevention of the postoperative recurrence of multinodolar goiter .Method:The patients with multinodolar goiter were divided into two groups:L-T4 group and control group ( without L-T4) .The patients were followed up for a long time , examined by B-ultrasonic or CT.The relationship between L-T4 and postoperative recurrence and that between administration duration and the postoperative recurrence was observed .Result:The recurrence rate in 1161 patients was 9.24%.And that in L-T4 group(5.37%) was lower than that in control group (22.09%) ,the difference was of statistical-ly significant (P<0.05).The recurrence rate in group of L-T4 in one year was significantly higher than that in 1 to 2 years ( P<0.05);There were no statistical difference in 1 to 2 years and 2 to 3 years,and 2 to 3 years and>3 years ( P>0.05) ;Patients with S-TSH≥3.6 recurrence rate compared with S-TSH<0.4 and 0.4≤S-TSH <3.6 in patients were significantly increased ( P <0.05) .Conclusion:Postoperative adminis-tration of L-T4 for one to two years and with S-TSH<3.6 uTU /mL can reduce the recurrence rate of multi-nodolar goiter .