成人亚临床甲状腺功能减退症替代治疗疗效观察

Clinical study of levothyroxine in treating adult patients with subclinical hypothyroidism

目的探讨左旋甲状腺素替代治疗成人亚临床甲状腺功能减退症(亚临床甲减)的临床疗效。方法成人亚临床甲减46例,在诊断初和经左旋甲状腺素治疗4周、12周时分别测定空腹血清总甲状腺素(TT4)、游离甲状腺素(FT4)、促甲状腺激素(TSH)、总胆固醇(TC)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)。结果亚临床甲减可致血脂增高,替代治疗12周后,甲状腺功能逐渐恢复正常,TC、LDL-C明显下降,HDL无明显变化。结论亚临床甲减患者接受左旋甲状腺素替代治疗可使甲状腺功能逐渐恢复正常,并可带来临床症状及血脂改善等益处。故对高危人群的筛查及针对性地行左旋甲状腺素替代治疗是必要的。

Objective To observe the clinical efficacy after levothyroxine treatment in the adult patients with subclinical hypothyroidism. Methods 46 patients with subclinical hypothyroidism were recruited.All patients were examined before and 4 weeks, 12 weeks after levothyroxine treatment.Fasting blood TT4, FT4,TSH,total cholesterol （TC）. Low density lipoprotein（LDL）, hight density lipoprotein（HDL） were determined. Results The subclinical hypothyroidism could result in the increasement of lipids. After substitutive therapy for 12 weeks ,thyroid function gradually improved to normal.TC ,LDL were significantly decreased. HDL were not significantly changed. Conclusion The administration of levothyroxine to patients with subclinical hypothyroidism made the thyroid function gradually improved to normal. Clinical symptoms and blood lipids were improved. So screen the high risk group and selective treatment with levothyroxine is necessary.