左甲状腺素钠治疗老年甲状腺功能减退临床分析

Clinical analysis on levothyroxine sodium in treatment of hypothyroidism in elderly patients

目的 探讨左甲状腺素钠治疗老年甲状腺功能减退的临床疗效及安全性。方法 选取本院2015年1～12月门诊就诊的老年甲状腺功能减退患者100例,随机分为观察组和对照组,每组50例,观察组采用左甲状腺素钠治疗,对照组采用甲状腺片治疗,比较两组的临床疗效、相关指标及不良反应发生情况。结果 1观察组明显好转36例,好转13例,总有效率为98.0%（49/50）,对照组明显好转23例,好转19例,总有效率为84.0%（42/50）,组间比较差异有统计学意义（P〈0.05）;2治疗后,两组FT3、FT4、TSH等指标均明显改善,与治疗前相比,差异有统计学意义（P〈0.05）,且观察组改善更为明显,与对照组比较差异有统计学意义（P〈0.05）;3观察组共出现不良反应1例,其发生率为2.0%（1/50）,对照组共出现不良反应2例,其发生率为4.0%（2/50）,组间比较差异无统计学意义（P〉0.05）。结论 左甲状腺素钠治疗老年甲状腺功能减退临床疗效优于甲状腺片,能显著改善老年患者脂代谢,且无明显不良反应,值得推广。

Objective To discuss the clinical effect and safety of levothyroxine sodium in treatment of hypothyroidism in elderly patients. Methods 100 elderly patients with hypothyroidism treated in our hospital from January 2015 to December 2015 were selected and randomly divided into observation group and control group, each with 50 cases. Patients in the observation group were given levothyroxine sodium, while those in the control group were given thyroid tablets. The clinical effects, relative parameters, and incidence rates of adverse reactions were compared between the two groups. Results （1）In the observation group, there were 36 cases of completely response, and 13 cases of partially response, with an overall response rate of 98.0% （49/50）; in the control group, there were 23 cases of completely response, and 19 cases of partially response, with an overall response rate of 84.0%（42/50）. The inter-group differences were significant（P〈0.05）. （2）Afier treatment, indicators of FT3, FT4, and TSH in both groups were significantly improved than those before treatment（P〈0.05）, and the improvement was more significant in the observation group than in the control group（P〈0.05）. （3）There was 1 case [2.0%（1/50）] of adverse reaction in the observation group, and there were 2 cases [4.0% （2/50）] of adverse reaction in the control group, showing no significant difference between two groups （P〉 0.05）. Conclusion Levothyroxine sodium has superior effect than thyroid tablets in treatment of hypothyroidism in elderly patients, which can significantly improve the lipid metabolism in elderly patients without evident adverse reaction, thus is worthy to be promoted.