局部免疫调节治疗自身免疫性甲状腺疾病临床研究

Clinical Study of Local Immunoregulation in the Treatment of Autoimmune Thyroid Diseases

目的探讨局部免疫调节治疗自身免疫性甲状腺疾病的临床效果.方法选取360例自身免疫性甲状腺疾病患者,采用数字表法将患者随机分为观察组(n=175)和对照组(n=185),对照组给予常规口服药物治疗,观察组给予口服药物+局部免疫调节治疗,观察两组治疗前后甲状腺体积、甲状腺功能、甲状腺自身抗体变化以及复发、不良反应情况.结果观察组治疗后甲状腺右叶和左叶甲状腺体积分别为(5.24±0.60)cm3和(6.32±0.48)cm3,明显低于对照组(P<0.05);观察组治疗后游离甲状腺素(FT4)、游离三碘甲状腺原氨酸(FT3)和促甲状腺激素(TSH)分别为(12.01±0.95),(3.00±0.57)pmol/L和(5.41±0.87)m U/L,明显低于对照组(P<0.05);观察组治疗后甲状腺过氧化物酶抗体(TPOAb)和甲状腺球蛋白抗体(TGAb)分别为(184.94±22.81)IU/m L和(322.41±50.95)IU/m L,明显低于对照组(P<0.05);观察组治疗后1 a复发率和不良反应发生率分别为12.42%和5.14%,明显低于对照组(P<0.05).结论局部免疫调节治疗自身免疫性甲状腺疾病有较好的临床效果,值得临床推广应用.

Objective To investigate the clinical effect of local immunoregulation in the treatment of autoimmune thyroid disease. Method 360 patients with autoimmune thyroid diseases were selected,the patients were randomly divided into the observation group（ n = 175） and the control group（ n = 185） by random digital table method,the control group was given conventional oral medication,while the observation group was given oral medication＋local immunoregulation,the thyroid volume,thyroid function,thyroid autoantibodies,recurrence and adverse reactions of the two groups before and after treatment were observed. Results The thyroid volume in the right lobe and left lobe of the thyroid gland in the observation group were（ 5. 24±0. 60） cm3 and（ 6. 32±0. 48） cm3,which was significantly lower than that in the control group（ P〈0.05）; After treatment,free thyroxine（ FT4）,free three iodine thyroxine（ FT3） and thyroid stimulating hormone（ TSH） in the observation group were（ 12. 01 ±0. 95）,（ 3. 00±0. 57） pmol/L and（ 5. 41±0. 87） m U/L,which were significantly lower than those in the control group（ P〈0.05）; After treatment,the thyroid peroxidase antibody（ TPOAb） and thyroglobulin antibody（ TGAb） in the observation group were（ 184. 94 ± 22. 81） IU/ml and（ 322. 41 ± 50. 95） IU/ml respectively,which were significantly lower than those of the control group（ P〈0.05）; The recurrence rate at 1 year after treatment andthe incidence of adverse reactions in the observation group were 12. 42% and 5. 14%,which were significantly lower than those in the control group（ P〈0.05）. Conclusion Local immunoregulation has a good clinical effect in the treatment of autoimmune thyroid disease,and is worthy of clinical application.