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目的：进一步了解ＭＡＣ（马法兰、阿糖胞苷和环磷酰胺）预处理方案对白血病患者骨髓移植后内分泌功能的影响。方法：用放射免疫法测定了２６例白血病患者用ＭＡＣ方案预处理骨髓移植（ＢＭＴ）前、后的甲状腺及肾上腺皮质功能。结果：所有患者ＢＭＴ前甲状腺及肾上腺皮质功能均正常。ＢＭＴ后１，３，６，１２，２４，３６，４８和６０个月时，血清中促肾上腺皮质激素（ＡＣＴＨ）及皮质醇（Ｃｒ）的平均水平与ＢＭＴ前比较无显著性差异（Ｐ＞０．０５）；ＢＭＴ后１，３及６个月，患者血清中促甲状腺素（ＴＳＨ）水平较移植前升高（Ｐ＜０．０１），７例患者发生甲状腺机能异常，其中６例在ＢＭＴ后６个月内逐渐恢复正常。结论：ＭＡＣ预处理方案对白血病患者肾上腺皮质功能无明显影响；ＢＭＴ后２８％患者出现甲状腺机能异常，但可在６个月内恢复正常，无需给予甲状腺素替代治疗，不影响长期存活者的生活质量
OBJECTIVE: To further understand the effect of MAC (Maffar, Cytarabine and cyclophosphamide) preconditioning regimens on the endocrine function of leukemia patients after bone marrow transplantation. METHODS: The thyroid and adrenocortical functions of 26 leukemia patients before and after bone marrow transplantation (BMT) pretreatment with MAC were determined by radioimmunoassay. Results: All patients had normal thyroid and adrenal cortex function before BMT. At 1,3,6,12,24,36,48 and 60 months after BMT, there was no significant difference in the average levels of adrenocorticotropic hormone (ACTH) and cortisol (Cr) in serum compared with before BMT (P> 0.05); At 1, 3 and 6 months after BMT, serum thyroid stimulating hormone (TSH) levels were higher than before transplantation (P<0.01). Seven patients had abnormal thyroid function, 6 of them were Gradually returned to normal within 6 months after BMT. Conclusion: The MAC conditioning regimen has no significant effect on adrenocortical function in patients with leukemia; 28% of patients with abnormal thyroid function after BMT, but can return to normal within 6 months without the need for thyroid hormone replacement therapy, and do not affect the lives of long-term survivors. quality