亚硒酸钠对桥本甲状腺炎患者血清甲状腺过氧化物酶抗体滴度及氧化应激水平的影响

Impact of selenium supplementation therapy on the thyroid perioxidase antibody levels and serum oxidative stress in patients with Hashimoto＇s thyroiditis

目的探讨亚硒酸钠治疗对桥本甲状腺炎患者甲状腺过氧化物酶抗体（TPO-Ab）和氧化应激水平的影响。方法将79名桥本甲状腺炎患者，随机分为亚硒酸钠组（治疗组）和安慰剂组（对照组）治疗24周。观察治疗前后血清甲状腺激素水平、TPO-Ab滴度、氧化应激水平[丙二醛（MDA）、谷胱甘肽过氧化物酶（GPx）和超氧化物歧化酶（SOD）]的变化。结果（1）治疗前后两组甲状腺激素水平无显著变化（P〉0.05）。（2）治疗组治疗后抗体水平降低（P〈0.05），抗体滴度≤200 IU/ml者和病程≤1年者降幅最大，分别为29.98%和26.63%，对照组无显著变化。（3）治疗后治疗组氧化应激水平降低（P〈0.05），氧化应激水平与抗体滴度呈正相关，对照组治疗后无显著变化。结论亚硒酸钠治疗可降低桥本甲状腺炎患者血清TPO-Ab滴度及氧化应激水平，病程较短和抗体滴度轻度升高者更明显。

ObjectiveTo observed the impact of selenium supplementation therapy on the thyroid perioxidase antibody（TPO-Ab） levels and serum oxidative stress[malondialdehyde（MDA, glutathione peroxidase（GPx）, and superoxide dismutase（SOD）] in patients with Hashimoto′s thyroiditis.Methods79 patients with Hashimoto′s thyroiditis were randomly divided into trial group（n=44） and placebo group（n=35） .The double-blind treatment was for 24 weeks. The thyroid hormone levels, serum TPO-Ab levels, and oxidative stress indexes（MDA, GPx, and SOD） of both groups were detected before and after treatment.Results（1）There was no change of thyroid hormone levels either before or after treatments of both groups（P〉0.05）. （2）TPO-Ab of the trial group decreased significantly after the treatment（P〈0.05）. While the placebo group has little change. Group with TPO-Ab≤200 IU/ml and the course≤1 year manifested the most obvious declines by 29.98% and 26.63% respectively. （3）The oxidative stress level of trial group significantly decreased after 24 weeks. There was significantly positive correlation between the oxidative stress indexes and TPO-Ab. However the placebo group was with little change. ConclusionSelenium supplementation may reduce the level of TPO-Ab titers and oxidative stress in patients with Hashimoto′s thyroiditis, especially for those with lower antibody titers and short course.