The Study Of Impact Of Preparation Before Radioiodine Therapy On Parathyroid Hormone,Vitamin D,Electrolyte Level

Objective:To observe and analyze the changes of serum PTH,vitamin D and electrolyte levels in patients with thyroid cancer after total thyroidectomy before and after ¹³¹I hospitalization preparation's intervention.Methods:From March 2017 to March 2018,a total of 382 patients,including 102 males and 280 females aged 12⁶6?40.09±10.84?,who received ¹³¹I inpatient treatment in the nuclear medicine department of the union hospital Tongji medical college of Huazhong university of science and technology.The included patient data were divided into three groups:?1?The group before preparation.PTH level,total 25?OH?D level,serum Ca²⁺level,serum P^3-level and serum Mg²⁺level were collected as baseline level for the last time before preparations for ¹³¹I inpatient treatment.?2?Post preparation group.PTH level,total 25?OH?D level,serum Ca²⁺level,serum P^3-level and serum Mg²⁺level were collected after preparations for ¹³¹I hospitalization.?3?Post-inpatient group.PTH level,total 25?OH?D level,serum Ca²⁺level,serum P^3-level and serum Mg²⁺level were collected after ¹³¹I hospitalization.The difference between the PTH level after preparation and the PTH baseline level was denoted as"?PTH",and the difference between the total25?OH?D level and the total 25?OH?D level after preparation was denoted as"?25?OH?D",and the difference between the serum P^3-level after preparation and the serum P^3-baseline level was denoted as"?P^3-".All patients were required to receive low iodine diet for one month before receiving radioactive iodine therapy,and the requirements were as follows:?1?Fast the seafood products including iodized salt and seaweed,fish and shrimp,avoid enhanced CT examination,avoid the use of iodine-containing drugs such as cydiodine Buccal Tablets,and try to eat less eggs,beef,milk,chicken essence,spinach,celery and soy sauce vinegar.?2?Thyroid hormone drugs will withdraw a week later.?3?Reexamination before radioactive iodine therapy.Results:1.Multiple linear regression analysis observed that patients'PTH level,total 25?OH?D level and serum P^3-level were closely correlated,while serum Ca²⁺and Mg²⁺only showed correlation with other indicators at specific time points.2.Simple linear regression analysis observed that the greater the change range of25?OH?D before and after preparation,the greater the change range of PTH increased accordingly,and when?25?OH?D>5.08nmol/L,?PTH began to show an upward trend;The lower the level of 25?OH?D after preparation,the greater the change range of PTH before and after preparation.In addition,when the level of 25?OH?D<41.71nmol/L after preparation,PTH begins to show an upward trend.The greater the decrease of 25?OH?D before and after the preparation,the higher the PTH would rise,and when the decrease of25?OH?D exceeded 12.78nmol/L,the PTH would rise beyond the upper limit of normal value?65pg/mL?after the preparation.Serum P^3-increased with the change of PTH before and after preparation.3.PTH level of patients after preparation was significantly higher than that before preparation and after hospitalization,and PTH level before preparation was significantly higher than that after hospitalization.The level of total 25?OH?D after preparation was significantly lower than that before preparation and after hospitalization,and the level of total 25?OH?D before preparation was significantly higher than that after hospitalization.There was no significant difference in serum Ca²⁺level.Serum P^3-level after preparation was significantly higher than that before preparation and after hospitalization.Serum P^3-level before preparation was significantly higher than that after hospitalization.Serum Mg²⁺level after preparation was significantly higher than serum Mg²⁺level after hospitalization.Conclusion:1.After preparations for ¹³¹I hospitalization,patients'vitamin D level decreased,which directly affected the increase of PTH level.2.Before and after preparation,the greater the fluctuation of patients'vitamin D level,the greater the fluctuation of PTH level.When the fluctuation of vitamin D level exceeded5.08 nmol/L,PTH showed an upward trend.After preparation,the patient's vitamin D level<41.71nmol/L,and PTH showed an upward trend.When the patient's vitamin D decreased by more than 12.78nmol/L,the PTH level will exceed the upper limit of normal value after preparation,that is,hyperparathyroidism.3.Severe hypothyroidism after the withdrawal of thyroid hormone leads to the increase of serum P^3-level in patients,which may lead to the increase of PTH level with deceased vitamin D level.