口服亚硒酸钠和维生素E对高海拔地区心血管病患者甲状腺激素的影响

Influence of oral sodium selenite and vitamin E on thyroid hormones in patients with cardiovascular disease at altitude

目的 探讨使用亚硒酸钠和维生素E对高海拔地区心血管病患者甲状腺激素的影响。方法 将心血管病患者随机分为 3组 :A组 4 2例患者口服亚硒酸钠 ,同时加服维生素E ;B组 2 8例患者口服亚硒酸钠 ;对照组 2 0例 ,未服用亚硒酸钠及维生素E。观察对象分别于治疗前和治疗 6个月后抽血检测血清硒 (Se)、血浆谷胱甘肽过氧化物酶 (GSH Px)活力、丙二醛 (MDA)含量及甲状腺激素(T3 、T4)等指标 ,以观察远期疗效。结果 治疗后A组和B组血清Se含量 [(0 .71± 0 .2 2 )、(0 .6 8±0 .18) μmol/L]明显高于治疗前 [(0 .31± 0 .17)、(0 .33± 0 .14 ) μmol/L],差异有显著性 (P <0 .0 1) ;A组和B组血浆GSH Px活力分别为 (87.12± 13.6 1)、(84 .79± 12 .13)U/L ,较治疗前 [分别为 (5 8.4 3± 18.93)、(5 7.12± 17.36 )U/L]明显增加。A组和B组MDA含量 [(4.86± 1.18)、(4.18± 1.2 3)nmol/ml]较治疗前 [(8.6 6± 0 .96 )、(8.71± 0 .87)nmol/ml]明显降低 ,差异均有显著性 (P <0 .0 1) ;A组和B组患者T3 和T4较对照组明显降低 ,趋于正常。血清Se与血浆GSH Px呈正相关 (r=0 .781,P <0 .0 1) ,与MDA、T3 、T4浓度呈负相关 (r=- 0 .385 ;r=- 0 .6 87;r=- 0 .4 12 ,均P <0 .0 5 )。甲状腺激素恢复正常者A组 31例 (73.81% )?

Objective To investigate the effect of oral sodium selenite and vitamin E on thyroid hormones in patients with cardiovascular disease at altitude. Methods Ninety patients with cardiovascular disease were divided into A group(n=42,sodium selenite+VE),B group(n=28,sodium selenite only) and control group(n=20).Serum selenium(Se),plasma glutathione peroxidase(GSH Px),plasma malondialdehyde(MDA) and serum T 3 and T 4 were determined before and after 6 month treatment. Results Serum Se in A and B group after 6 month treatment were higher than before[(0.71± 0.22) μmol/L vs (0.31±0.17)μmol/L,(0.68±0.18)μmol/L vs (0.33±0.14)μmol/L respectively, P <0.01],and so were plasma GSH Px levels[(87.12±13.61)U/L vs (58.43±18.93)U/L,(84.79±12.13)U/L vs (57.12±17.36) U/L respectively] while plasma MDA were lower than before[(4.86±1.18)nmol/ml vs (8.66± 0.96 )nmol/ml,(4.18±1.23)nmol/ml vs (8.71±0.87)nmol/ml respectively, P <0.01].Serum T 3 and T 4 levels in A and B group were also obviously decreased( P < 0.01). The levels of plasma GSH Px were positively correlated with those of serum Se(r=0.781, P <0.01).The levels of plasma MDA and serum T 3 and T 4 were negatively correlated with those of serum Se( r =-0.385, -0.687, -0.412 respectively, P <0.05).31 cases(73.81%) in A group and 20 cases(71.42%) in B group completely recovered to normal;4 cases(9.52%) in A group and 2 cases(7.43%) in B group partly recovered.The recovered rates were significantly different from that of control( P <0.05). Conclusion Supplementation of adequate selenium may correct the abnormal function of secretion in thyroid hormones of patients because of lack of selenium at altitude areas.