目的 探讨老年恶性肿瘤患者的甲状腺功能状态及化学药物疗法(简称化疗)对其甲状腺功能的影响。方法 选取2010-01至2014-02确诊的老年恶性肿瘤患者398例,并选择400例体检老年人群作为健康对照组,进行甲状腺激素(thyroid hormone,TH)和促甲状腺激素(thyroid stimulating hormone,TSH)水平测定。将激素水平正常,KPS (Karnofsky)评分＞60的老年恶性肿瘤患者分为: 肿瘤治疗组132例,肿瘤对照组 129例。两组年龄、KPS评分无统计学差异。肿瘤治疗组患者进行相应化疗,观察治疗前及治疗后6个月的TH和TSH水平,肿瘤对照组仅给予对症治疗,同期比较两组TH和TSH水平,分析化疗对老年恶性肿瘤患者甲状腺功能的影响。结果 398例老年恶性肿瘤患者的TH、TSH与健康对照组相比差异无统计学意义(P>0.05)。肿瘤治疗组患者的TH、TSH与肿瘤对照组相比,TSH的差异存统计学意义(P＜0.05)。肿瘤治疗组中甲状腺功能减退(甲减)的比例为7.58％,亚临床型甲减的比例为23.48％。肿瘤对照组中甲减的比例为5.65％,亚临床甲减的比例为5.65％。两组比较,亚临床型甲减的发生率存在统计学差异(P＜0.05)。结论 老年恶性肿瘤患者的甲状腺功能异常发生率与健康群体比较无统计学差异,化疗对老年恶性肿瘤患者的甲状腺功能有一定的影响。

Objective To study thyroid functional status of the aged patients with malignant tumors and the relationship between thyroid function with chemotherapy. Methods 398 aged patients with malignant tumors were recruited as the pathological group. At the same time, 400 aged healthg subjects served as the control group. The thyroid hormones (thyroid hormone, TH), and thyrotropin (thyroid stimulating hormone, TSH) levels were measured. The thyroid function in the groups was analyzed and compared. When KPS score is over 60, the aged patients with malignant tumors in normal hormone levels were divided into the observation group (132 cases) and the control group (129 cases).Two groups had no significant difference in the age and KPS score. The patients in the observation group were treated by chemotherapy and TH and TSH levels observed before treatment and 6 moths post-treatment. The patients in the control group were given symptomatic treatment, TH and TSH levels were observed over the same period. We compared thyroid hormone and thyroid hormone levels and analyzed the relationship between thyroid function with chemotherapy in the aged patients with malignant tumor. Results The thyroid hormone and thyroid stimulating hormone in 398 aged patients with malignant tumor were compared with those in the healthy control group, the difference was not statistically significant (P＜0.05). The aged patients with malignant tumors in normal hormone levels were divided into the observation group and the control group. In observation group the hypothyroidism (hypothyroidism) ratio was 7.58%, the proportion of subclinical hypothyroidism was 23.48%, hyperthyroidism (hyperthyroidism) ratio was 1.51%, and subclinical hyperthyroidism ratio was 2.27%. In control group, the proportion of hypothyroidism was 5.65%, subclinical hypothyroidism ratio was 5.65%, hyperthyroidism ratio was 1.61% and subclinical hyperthyroidism ratio was 3.23%. In the observation group, the thyroid disease incidence rate was higher. Incidence of subclinical hypothyroidism in the two groups was significantly different (P＜0.05). Conclusions The thyroid dysfunction in the aged patients with malignant tumor was not significantly different compared with the health control group. Chemotherapy in the aged patients with malignant tumor harms the thyroid function to some extent. The detection of thyroid function in the aged patients with malignant tumor has clinical significance.