亚硒酸钠治疗桥本甲状腺炎的临床观察

Clinical observation of treating autoimmune thyroiditis with Sodium selenite

目的探讨硒对成人桥本甲状腺炎(HT)的干预效果。方法将176例HT患者中的甲状腺功能正常者121例和甲状腺功能减退(甲减)及亚临床甲减患者55例,分别分为对照组及治疗组,对照组根据甲状腺功能给予不用药或加用左旋甲状腺素片处置,治疗组在对照组治疗的基础上加用亚硒酸钠,观察亚硒酸钠对患者甲状腺过氧化物酶抗体(TPOAb)、甲状腺球蛋白抗体(TGAb)、甲状腺功能的影响。结果甲状腺功能正常组中硒治疗组患者的TPOAb、TGAb明显下降,与对照组比较差异有统计学(P<0.01,P<0.05﹚,而甲状腺功能方面,与对照组比较差异无统计学意义(P>0.05)。甲减及亚临床甲减组,随着TSH的下降,两组TPOAb、TGAb均有不同程度下降,但硒治疗组下降更明显,两组治疗前后比较差异有统计学意义(P<0.05﹚。硒治疗组无明显不良反应。结论补硒能降低HT患者甲状腺的自身抗体水平,可在一定程度上阻止甲状腺损害的发生和发展。

Objective To observe the effect of selenium on adult autoimmune thyroiditis.Methods A total of 176 patients of autoimmune thyroiditis with normal thyroid-function（n=121） or hypothyroidism（n=55） were randomly divided into control group and trial group.The control group were given a standard treatment（without medication or with levothyroxine）,and the trial group additionally given Sodium selenite.The changes in autoantibodies to thyroid peroxidase（TPOAb）,thyroglobulin antibodies（TGAb） and thyroid-function were compared between the two groups after three months.Results The patients of normal thyroid-function： TPOAb and TGAb levels were more significantly decreased in the trial group than in the control group（P0.01,P0.05）;thyroid-function were little changed without statistic difference between the two groups（P0.05）.The patients of hypothyroid and subclinical hypothyroid： although thyroid stimulating hormone（TSH）,TPOAb and TGAb levels declined in both the two groups,the changes were more significant in the trial group（P0.05）.There was no evident side-effect in selenium-treated group.Conclusion Selenium helps to reduce thyroid autoantibody level in patients of autoimmune thyroiditis,and prevent occurrence and development of thyroid damage in a certain extent.