曲安西龙可促进桥本氏病伴甲减的甲状腺功能恢复

Triamcinolone can improve the recovery of thyroid fuction from the hypothyroidism in Hashimoto thyroiditis

目的:研究曲安西龙对桥本氏病伴甲减的疗效。方法:桥本氏病伴甲减患者共60例,随机分为曲安西龙组和对照组。两组于治疗前及治疗后4个月时分别测定血清游离三碘甲状腺原氨酸、游离甲状腺素、促甲状腺素(TSH)、甲状腺球蛋白抗体(TgAb)、甲状腺过氧化物酶抗体(TPOAb)、血浆皮质醇、促肾上腺皮质激素及血浆葡萄糖水平。结果:治疗后曲安西龙组TSH较对照组显著改善(P均<0.05),TgAb和TPOAb也明显下降(P均<0.05),且治疗所需左旋甲状腺素的平均剂量为39±20μg/d,明显低于对照组(P<0.05)。结论:曲安西龙能明显降低血清TgAb和TPOAb水平,增强左旋甲状腺素对桥本氏病伴甲减的疗效,更快恢复甲状腺功能。

Objective：To observe the therapeutic effect of triamcinolone on hypothyroidism caused by Hashimoto thyroiditis.Methods：Totally 60 patients with hypothyroidism caused by Hashimoto thyroiditis were randomized into triamcinolone group and control group.Thyroid funtions,including free triiodothyronine,free thyroxine,thyroid-stimulating hormone（TSH）,were examined before treatment and 4 months after the treatment.The serum autoantibodies,including thyroglobulin antibody（TgAb）and thyroid peroxide antibody（TPOAb） were measured,and serum cortisol,adrenocorticotropic hormone,and plasma glucose were detected.Results：After 4-month of the treatment,the levels of TSH of triamcinolone group were improved significantly（P〈0.05）,TgAb and TPOAb decreased significantly when compared to those of control group（P〈0.05）.Triamcinolone group required lower average dose of L-thyroxine（79±30 μg/d）,and significant difference was found when compared to that of the control group（P〈0.05）.Conclusion：Triamcinolone can significantly reduce the levels of serum TgAb and TPOAb and improve the therapeutic effect of L-thyroxine,resulting in the faster recovery of thyroid functions.