左旋甲状腺素治疗亚临床甲状腺功能减退的疗效及对血脂的影响

The effect of levothyroxine in treatment with subclinical hypothyroidism and its affection on blood fat

目的观察左旋甲状腺素治疗亚临床甲状腺功能减退的疗效及对血脂的影响。方法 2009年12月～2011年12月在我院住院治疗的112例亚临床甲状腺功能减退患者随机分为两组,观察组56例给予左旋甲状腺素治疗,对照组56例给予六味地黄丸治疗,比较观察两组的治疗效果及其血脂水平的变化。结果观察组治疗后TSH水平明显下降,FT3、FT4水平明显升高,与治疗前比较差异均有统计学意义(P<0.05);而对照组治疗前后TSH、FT3、FT4水平比较,差异无统计学意义(P>0.05)。观察组治疗后TSH水平明显低于同期对照组(P<0.05),FT3、FT4水平明显高于同期对照组(P<0.05)。治疗后,观察组TC、TG和LDL水平明显下降(P<0.05),HDL水平无明显变化(P>0.05);而对照组治疗前后TC、TG、LDL和HDL水平比较,差异无统计学意义(P>0.05)。且观察组治疗后TC、TG和LDL水平明显低于同期对照组(P<0.05),而HDL与对照组比较,差异无统计学意义(P>0.05)。结论左旋甲状腺素对亚临床甲状腺功能减退患者进行治疗能够明显降低TSH,升高FT3、FT4水平,降低血脂,是一种治疗亚临床甲状腺功能减退的良好选择。

Objective To observe the clinical effect of levothyroxine in treatment of subclinical hypothyroidism and its af- fection on blood fat. Methods From December 2009 to December 2011, 112 cases of subclinical hypothyroidism patients were randomly classified into two groups, which observation group with 56 cases was treated with levothyroxine and control group with 56 cases was treated with liuweidihuangwan. The clinical effect blood fat and levels of blood fat were compared. Results Compared with pre-treatment, the levels of TSH were significantly decreased（P 〈 0.05）, the level of FT3, FT4 were significantly increased （P 〈 0.05）after treatment in observation group. However, there were no significant differences in control group （P 〉 0.05）. Moreover, the levels of TSH in observation group were significantly lower than those in control group （P 〈 0.05）, the level of FT3, FT4 were significantly higher than those in control group （P 〈 0.05）after treatment. Compared with pre-treatment, the levels of TC, TG and LDL were significantly decreased （P 〈 0.05）, the level of HDL was not significantly changed （P 〈 0.05） after treatment in observation group. However, there were no significant differences in control group （P 〉 0.05）. Moreover, the levels of TC, TG and LDL were significantly lower in observation group than those in control group （P 〈 0.05）, the levels of HDL were not significantly different from control group （P 〉 0.05）. Conclusion Levothyroxine in treatment of subclinical hypothyroidism can decrease TSH, improve FT3, FT4, and reduce blood fat, which is a good choice for subclinical hypothyroidism.