硒酵母联合甲巯咪唑治疗Graves病合并甲亢的临床研究

Clinical Study on Effct of Selenium Combining with Methimazole in Graves' Disease Patients with Hyperthyroidism

目的:观察硒酵母联合甲巯咪唑治疗Graves病合并甲亢的临床疗效及其对甲状腺激素、自身抗体和免疫球蛋白(Ig)水平的影响。方法:选择2011年1月-2012年12月在本院就诊的Graves病合并甲状腺功能亢进的患者80例,随机分为观察组和对照组,每组均为40例;对照组予以甲巯咪唑治疗,观察组在对照组的基础上予以硒酵母治疗。观察两组治疗后的疗效及其对游离三碘甲腺原氨酸(FT3)、游离酶四碘甲腺原氨酸(FT4)、促甲状腺激素激素(TSH)、甲状腺球蛋白抗体(TGAb)、促甲状腺激素受体抗体(TRAb)、甲状腺过氧化物酶抗体(TPOAb)及Ig A、Ig G和Ig M水平的影响。结果:对照组的总有效率为72.50%,观察组的总有效率为92.50%,观察组的总有效率明显优于对照组(χ2=4.242,P<0.05)。治疗后FT3、FT4、TGAb、TPOAb、TRAb、Ig G、Ig A和Ig M水平较治疗前明显降低,TSH较治疗前明显升高,有显著统计学意义(P<0.01),观察组FT3、FT4、TGAb、TPOAb、TRAb、Ig G和Ig A降低水平更为明显,与对照组比较,有明显统计学意义(P<0.01);TSH升高亦有统计学意义(P<0.01);而两组的Ig M水平差异无统计学意义(P>0.05)。结论:硒酵母联合甲巯咪唑治疗Graves病合并甲亢的疗效肯定,具有调节Graves病免疫功能作用。

Objective： To observe the efficacy of selenium combining with methimaole in Graves＇ disease patients with hyperthyroidism,and its impact on the levels of thyroid hormones,autoantibodies and immunoglobulins（ Ig）. Methods： 80 Graves＇ disease patients with hyperthyroidism,were randomly divided into observation group and control group,each group had 40 cases. The control group gaved methimazole,the observation group were given selenium on the basis of the control group. The efficacy after treatment,and its free thyronine（ FT3）,free four iodine thyronine（ FT4）,thyroid stimulating hormone（ TSH）,thyroglobulin antibody（ TGAb）,thyroid- stimulating hormone receptor antibody（ TRAb）,thyroid peroxidase antibody（ TPOAb）,Ig A,Ig G and Ig M were observed before and after treatment in each groups. Results： The total effective rate was92. 50 % in observation group was better than 72. 50% in control group（ χ2= 4. 242,P〈0. 05）. After treatment,the levels of FT3,FT4,TGAb,TPOAb,TRAb,Ig G,Ig A and Ig M were significantly lower than those before treatment（ P〈0. 01）,and the levels of FT3,FT4,TGAb,TPOAb,TRAb,Ig G and Ig A in observation group reduced more significant than those in control group（ P〈0. 01）,TSH level was obviously raised after treatment（ P〈0. 01）,while the Ig M level showed no significant difference in two groups（ P〉0. 05）. Conclusion： The efficacy of selenium in Graves＇ disease patients with hyperthyroidism is obvious,that can regulate the immune function of Graves disease.