硒酵母联合左旋甲状腺素片治疗桥本甲状腺炎的临床疗效观察

Selenium yeast combined with levothyroxine tablets in treatment of Hashimoto's thyroiditis

目的探讨硒酵母联合左旋甲状腺素片治疗桥本甲状腺炎的临床效果。方法选择桥本甲状腺炎患者86例,随机分为研究组与对照组(各43例)。研究组采用硒酵母+左旋甲状腺素片治疗,对照组采用左旋甲状腺素片治疗,比较两组治疗前后甲状腺功能指标和甲状腺自身抗体水平。结果治疗后,研究组血清促甲状腺激素(TSH)水平(4.91±1.98 m U/L)显著低于对照组(7.15±2.29 m U/L),血清游离三碘甲状腺原氨酸(FT3)、血清游离甲状腺素(FT4)水平(5.19±1.23 pmol/L,16.98±2.98 pmol/L)显著高于对照组(3.89±0.81 pmol/L,12.33±2.38);治疗后研究组血清甲状腺球蛋白抗体(TGAb)、抗甲状腺过氧化物酶抗体(TPOAb)水平(67.2±10.4 U/ml,128.4±39.4 pmol/L)显著低于对照组(89.4±11.2 U/ml,188.2±29.4 pmol/L);不良反应发生率(6.98%)显著低于对照组(23.26%),差异均有显著性(P<0.05)。结论桥本甲状腺炎患者接受硒酵母联合左旋甲状腺素片治疗可有效提高患者的甲状腺功能,降低患者甲状腺自身抗体水平,具有较好的治疗效果。

Objective To investigate selenium yeast combined with levothyroxine tablets in treatment of Hashimotog thyroiditis. Methods 86 patients with Hashimoto＇s thyroiditis were collected and randomly divided into study group and control group （43 patients each）. In the study group, the combined use of selenium yeast and levothyroxine tablets was taken in the treatment and in control group, levothyroxine tablets therapy was taken only. The therapeutic effect was compared. Thyroid function indicators and thyroid autoantibodies were compared before and after treat- ment. Results After treatment, serum TSH level （4.91±1.98 mU/L） in study group was significantly lower than the control group （7.15 ±2. 29 mU/L）, and FT3, FT4 levels （5.19±1.23 pmol/L, 16.98±2.98 pmol/L） were significantly higher than control group （3.89±0.81 pmol/ L, 12.33±2.38 pmol/L） （ P 〈 0.05 ）. After treatment, serum thyroglobulin autoantibodies （TGAb） , thyroid peroxidase autoantibodies （ TPO- Ab） levels （67.2± 10.4 U/ml, 128.4±39.4 pmol/L） in study group were significantly lower than the control group （ 89.4±11.2 U/ml, 188. 2±29.4 pmol/L） （ P 〈0. 05 ）. Adverse reactions （6.98%） in study group were significantly lower than the control group （ 23.26% ） （ P 〈 0. 05）. Conclusion Patients with Hashimoto＇s thyroiditis receiving selenium yeast and levothyroxine treatment can improve the patient＇s thyroid function, decrease thyroid autoantibedies levels in patients, which has better therapeutic effect.