中文摘要：

目的探讨TSH抑制治疗对于绝经后DTC患者骨密度的影响。方法收集2009年9月至2014年12月上海交通大学医学院附属新华医院核医学科收治的DTC术后、绝经后患者。分别于清除甲状腺残留组织（简称清甲）、清除复发或转移灶（简称清灶）治疗前后，用双能x线骨密度仪测量腰椎骨密度（T值）。所有患者均在清甲或清灶治疗后常规口服甲状腺激素。根据TSH水平将患者分成TSH抑制组（中位TSH〈0．30mU／L）和对照组（中位TSH≥0．30mU／L）。采用Mann—Whitney1／,检验和Kruskal—Wallis检验分析数据。结果共纳入患者126例，其中TSH抑制治疗组65例[平均年龄（57．65±6．65）岁]、对照组61例[平均年龄（56．19±7．17）岁]；均随访2年。TSH抑制治疗组和对照组治疗前T值分别为-1．70（-2．30，-0．55）和-1．30（-2．10，-0．30）（z=-1．660，P〉0．05）。TSH抑制组治疗前T值和随访1年及2年-2．25（-2．48，-0．83），-1．95（-2．70，-0．60）]比较，差异有统计学意义（日=6．244，P〈0．05）；对照组治疗前后T值差异无统计学意义（日=1．102，P〉0．05）。随访1年和2年，aSH抑制治疗组与对照组的T值差异均有统计学意义（z值：-2．170和-2．160，均P〈0．05）。结论TSH抑制治疗是绝经后DTC患者骨量减少的危险因素，在其长期随访中应定期检测骨密度。

英文摘要：

Objective To investigate the effect of postoperative TSH suppression on bone mineral den- sity （BMD） in postmenopausal women with DTC. Methods Postmenopausal women with postoperative DTC un- derwent thyroid residual ablation or t31I treatment for metastases at Xin Hua Hospital between September 2009 and December 2014 were enrolled and followed for 2 years. They were divided into suppressive TSH group （ median TSH〈0.30 mU/L ; group 1 ） and non-suppressive group （ median TSH t〉 0.30 mU/L; group 2）. Lumber 1-4 BMD levels （T scores） were measured by a dual energy X-ray absorptiometry bone densitome- ter at baseline, 1 year and 2 years after treatment. All patients had calcium and vitamin D supplementation after TSH suppression. The T scores were compared with Mann-Whitney u test and Kruskal-Wallis test. Re- suits A total of 126 patients were enrolled and followed up for 2 years, including 65 with average age （57.65±6.65） years in group 1 and 61 with average age （56.19±7.17） years in group 2. The T scores in group 1 and group 2 at baseline were -1.70（-2.30, -0.55） and -1.30（-2.10, -0.30）（z=-1.660, P〉 0. 05）. The difference of T scores was significant in group 1 at baseline, 1-year follow-up and 2-year follow- up （-2.25（-2.48, -0.83）, -1.95（-2.70, -0.60） ; H=6.244, P〈0.05）, but not significantly different in group 2 （H= 1.102, P〉0.05）. The T values were different between the 2 groups both in 1-year follow-up and 2-year follow-up （z values： -2.170, -2.160, both P〈0.05）. Conclusions TSH suppression signifi- candy increases the risk of postoperative osteoporosis. The BMD should be followed up annually in postm- enopausal DTC patients.