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目的观察分化型甲状腺癌(DTC)术前及术后4周血脂的变化,探讨甲状腺功能低下对血脂的影响。方法回顾性分析2014年1月~2016年1月间DTC行近全切除术后的患者38例,将术前血液检查证实为高脂血症的患者15例作为实验组,无高脂血症患者23例作为对照组,分别于术前和术后4周检测低密度脂蛋白(LDL-C)、高密度脂蛋白(HDL-C)、总胆固醇(CHOL)、甘油三酯(TG),并对结果进行比较。结果所有患者术后4周的LDL-C,CHOL,TG与术前比较,差异均有统计学意义(P<0.05);在术前或术后4周,实验组的LDLC,CHOL,TG均高于对照组,差异均有统计学意义(P<0.05);所有患者术前及术后4周LDL-C,CHOL,TG变化(术后血脂数值减去术前血脂数值)比较,其差异均有统计学意义(P<0.05),且实验组变化幅度较对照组更加明显。HDL-C在上述各组比较中差异均无统计学意义(P>0.05)。结论 DTC患者在术后4周(未服用甲状腺素制剂)体内甲状腺素明显低下的情况下,LDL-C,CHOL,TG会有不同程度的增高;术前有高脂血症的DTC患者在术后4周LDL-C,CHOL,TG较无高脂血症的患者升高幅度大。
Objective To observe the changes of serum lipids in differentiated thyroid carcinoma (DTC) before and after 4 weeks and to investigate the effect of hypothyroidism on serum lipids. Methods A retrospective analysis of 38 patients with subtotal resection of DTC between January 2014 and January 2016 was performed. Fifteen patients with confirmed preoperative blood test as hyperlipidemia were selected as the experimental group without hyperlipidemia Twenty-three patients were enrolled as control group. LDL-C, HDL-C, CHOL, triglyceride (TG) were measured before and 4 weeks after operation. And compare the results. Results The LDL-C, CHOL, TG in all patients at 4 weeks postoperatively were significantly different from those before operation (P <0.05). LDLC, CHOL and TG in the experimental group (P <0.05). The changes of LDL-C, CHOL and TG in preoperative and postoperative 4 weeks (the value of postoperative serum lipids minus preoperative blood lipids) were significantly higher than those in control group (P <0.05), and the experimental group more obvious changes than the control group. There was no significant difference in HDL-C between the above groups (P> 0.05). CONCLUSIONS: LDL-C, CHOL and TG are increased to some extent in patients with DTC after 4 weeks of surgery (without taking thyroxine). In patients with DTC before and after treatment with hyperlipidemia, After 4 weeks, LDL-C, CHOL, TG were higher than those without hyperlipidemia.