| 马春文,晋建华,刘海燕.基于甲状腺乳头状癌术后患者131I治疗前甲状旁腺激素水平预测治疗后永久性甲状旁腺功能减退症[J].中国医学影像技术,2025,41(12):1990~1994 |
| 基于甲状腺乳头状癌术后患者131I治疗前甲状旁腺激素水平预测治疗后永久性甲状旁腺功能减退症 |
| Predicting permanent hypoparathyroidism in papillary thyroid carcinoma patients after surgery and 131I therapy based on parathyroid hormone level before 131I therapy |
| 投稿时间：2025-03-25 修订日期：2025-12-15 |
| DOI：10.13929/j.issn.1003-3289.2025.12.011 |
| 中文关键词: 甲状腺肿瘤 甲状旁腺功能减退症 碘放射性同位素 治疗学 |
| 英文关键词:thyroid neoplasms hypoparathyroidism iodine radioisotopes therapeutics |
| 基金项目:国家自然科学基金(82372009)、山西省高等教育"百亿工程"科技引导专项(BYYX004)。 |
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| 中文摘要: |
| 目的 观察131I治疗前甲状腺乳头状癌(PTC)术后患者甲状旁腺激素(PTH)水平用于预测治疗后永久性甲状旁腺功能减退症(HP)的价值。方法 回顾性收集接受131I治疗的137例PTC术后患者,记录术前及术后1、10天,以及131I治疗前及后1、6和12个月PTH水平。依据131I治疗前PTH水平划分PTH减低组(36例)与PTH正常组(101例),观察组内不同时间点PTH变化;同时根据131I治疗后12个月PTH水平划分永久性HP组(25例)与非永久性HP组(112例),筛选永久性HP影响因素,评估术后1、10天,以及131I治疗前PTH水平用于预测永久性HP的价值。结果 131I治疗前与治疗后1、6及12个月,整体PTH水平差异均无统计学意义(P均＞0.05)。PTH减低组术后1、10天,以及131I治疗前及治疗后1个月差异均无统计学意义(P均＞0.05)。131I治疗前PTH水平(OR=0.721,P=0.001)是PTC术后患者131I治疗后发生永久性HP的独立预测因素;以14.19 pg/ml为临界值,其预测永久性HP的敏感度和特异度均为92.00%,曲线下面积为0.957,最大约登指数为0.840。结论 基于131I治疗前PTC术后患者PTH水平能很好地预测永久性HP。 |
| 英文摘要: |
| Objective To explore the value of parathyroid hormone (PTH) level in papillary thyroid carcinoma (PTC) patients after surgery before 131I therapy for predicting permanent hypoparathyroidism (HP) after 131I therapy. Methods Totally 137 postoperative PTC patients who received 131I therapy were collected retrospectively. Serum PTH levels before, 1 and 10 days after surgery, also before and 1, 6 and 12 months after 131I therapy were recorded. Then the patients were divided into PTH reduction group (36 cases) and PTH normal group (101 cases) based on PTH levels before 131I therapy, and PTH changes at different time points within the group were analyzed. According to PTH levels 12 months after 131I therapy, the patients were divided into permanent HP group (25 cases) and non permanent HP group (112 cases), and the impact factors of permanent HP were screened, and the predictive value of PTH levels on permanent HP 1, 10 days after surgery and before 131I therapy were analyzed. Results No significant difference of overall PTH levels was found before and 1, 6 and 12 months after 131I therapy (all P＞0.05). No significant difference of PTH levels was detected in PTH reduction group 1, 10 days after surgery, nor before and 1 month after 131I therapy (all P＞0.05). PTH before 131I therapy (OR=0.721, P=0.001) was an independent predictor for permanent HP in postoperative PTC patients after 131I therapy. Taken 14.19 pg/ml as the critical value of PTH, its sensitivity and specificity for predicting permanent HP were both 92.00%, with the area under the curve of 0.957 and the maximum Youden index of 0.840. Conclusion PTH level in PTC patients after surgery before 131I therapy could be used to effectively predict permanent HP. |
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