查詢結果分析
相關文獻
- 無甲狀腺病人甲狀腺素停用與否之精神評量
- 分化型甲狀腺癌與懷孕
- 分化型甲狀腺癌手術後的促甲狀腺激素抑制療法
- Bone Mineral Density in Women Receiving Thyroxine Suppressive Therapy for Differentiated Thyroid Carcinoma
- 基因學於分化型甲狀腺癌之臨床應用
- Simultaneous Integrated Boost Intensity-Modulated Radiotherapy for Locally Advanced Anaplastic Thyroid Cancer
- 分化型甲狀腺癌治療指引
- 從美國及歐洲共識談分化型甲狀腺癌之處理
- 分化型甲狀腺癌之治療
- 分化型甲狀腺癌的術後風險分期與放射性碘治療
頁籤選單縮合
題名 | 無甲狀腺病人甲狀腺素停用與否之精神評量=Psychological Status in Athyreotic Patients With and Without Thyroxine Treatment |
---|---|
作者 | 陳明容; 葉啓彬; 洪鈞澤; 黃文盛; | 書刊名 | 核子醫學雜誌 |
卷期 | 19:2 民95.06 |
頁次 | 頁77-82 |
分類號 | 415.931 |
關鍵詞 | 分化型甲狀腺癌; 精神量表; 停用甲狀腺素; Differentiated thyroid carcinoma; Psychological scales; Thyroxine withdrawal; |
語文 | 中文(Chinese) |
中文摘要 | 背景:國內分化型甲狀腺癌病人有增無減;在適當醫療處置下有良好預後,但在追蹤過程中常須停用甲狀腺治療以促使血中甲狀腺刺激素升高進行血液甲狀腺球蛋白測定抑或全身掃描了解病況。此一過程可導致甲狀腺功能低下症。有報告指出;甲狀腺功能低下可導致身體代謝異常與憂鬱現象發生。本研究以甲狀腺切除病人在接受抑制性甲狀腺治療及停藥狀態下,配合系列精神量表評估,了解甲狀腺癌病人停用甲狀腺素是否會產生異常精神狀態並獲得較客觀量化資訊以及用藥與否與量表變化相關性,以便進一步評估這些病患是否需要使用其他替代方式如改用人工合成甲狀腺刺激素注射,短期三碘甲狀腺素以減少甲狀腺功能過低所產生的副作用,抑或使用抗憂鬱藥物或給予適當的衛教及心理諮詢等。 方法:本研究收集30位無重大內科或外科病史且在最近三個月亦無使用足以影響精神異常藥物的分化型甲狀腺癌甲狀腺切除病人,在接受抑制性甲狀腺治療及停藥狀態下,分別進行疲勞指數問卷(The Epworth Sleepiness scale; ESS)及漢氏憂鬱症狀估量表(The Hamilton Rating scale for Depression; HAMD)。上述問卷分數越高表示程度越重。 結果:就目前所收集的病人分析得知停用甲狀腺素4週會呈現甲狀腺功能過低症,此時病人比較用藥時會出現有意義的疲勞、情緒低落及生活品質下降變化,即疲勞指數問卷以及漢氏憂鬱症狀估量表問卷均呈有意義的偏高現象;在使用抑制性甲狀腺素及停用甲狀腺素4週時的疲勞指數分別為平均值±標率差0.36±0.9(標準誤0.19)及2.73±4.52(0.96);漢氏憂鬱症狀估量分別為2.48±2.04(0.45)(P=0.01)及3.86±3.42(0.75)(P=0.03)。但其中在疲勞指數問卷中有一位、在漢氏憂鬱症狀估量表中有三位病人出現異於預估結果,須進一步評估。 結論:配合系列精神量表評估得知,分化型甲狀腺癌病患術後使用抑制性甲狀腺素及停用甲狀腺素4週時會呈現精神方面異常變化。建議對嚴重患者使用有別於傳統停用甲狀腺素促使甲狀腺刺激素升高的其他替代方式,這將有助於這些病人的長期照護。 |
英文摘要 | Background: Patients with differentiated thyroid carcinoma (DTC) are increasing here in Taiwan. Thyroid hormone withdrawal for a period of time to induce serum thyroid stimulating hormone (TSH) increase is needed to evaluate cancer status by performing serum thyroglobulin measurements and whole body scans. Data indicated that hypothyroid state has been found to be related to affective disorders. The aim of this study was to compare the psychological status in DTC patients before and four weeks thyroxine withdrawal using different established psychological scales. Methods: In the current study, a total 30 athyreotic patients were recruited. The functional status of thyroid hormone was determined by thyroid functional profiles including serum T3, T4 and TSH values measuring by commercial radioimmunoassay kits. The Epworth Sleepiness Scale (ESS) for fatigue evaluation, and the Hamilton Rating Scale for Depression (HAMD) for depression evaluation of those patients under treatment and four weeks' withdrawal of thyroxine. Higher scoring represents higher severity of the disorders. A HAMD score of greater than ten scores indicated the status of depression. The higher the score represents the more severe the depression. Results: Based on serum thyroid function profiles, the patients were hyperthyroid under thyroxine treatment and hypothyroid after four weeks thyroxine withdrawal. Significant differences between patients with and without thyroxine treatment in ESS and the HAMD were found. There are three cases fulfilled the criteria for assessing as the depression status (10%) defined by greater than ten scores in HAMD. However, reciprocal results were also found in one and three cases of ESS and HAMD evaluations, respectively. Further analyses are needed to explain the reciprocal results. Conclusion: Measuring psychological scales from patients with DTC during thyroxine treatment or withdrawal enable us to realize effects of thyroid status on psychological changes, which may provide a clue to decide if alternatives such as recombinant human TSH, T3 supplement or in conjunction with anti-psychotic medication are needed in follow-up procedures for patients with DTC. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。