硒酵母并左甲状腺素钠对桥本甲状腺炎伴甲状腺功能减退患者血硒和甲状腺自身抗体的影响

Effects of Selenium Yeast and Levothyroxine Sodium on Blood Selenium and Thyroid Autoantibodies in Patients with Hashimoto's Thyroiditis Complicated with Hypothyroidism

目的观察硒酵母并左甲状腺素钠对桥本甲状腺炎伴甲状腺功能减退患者血硒和甲状腺自身抗体的影响。方法选取我院2016年9月—2017年9月收治的桥本甲状腺炎伴甲状腺功能减退84例,随机分为对照组与观察组,每组各42例。两组均予左甲状腺素钠口服,观察组在此基础上口服硒酵母,均治疗3个月。检测治疗前后三碘甲状腺原氨酸(T3)、甲状腺素(T4)、促甲状腺激素(TSH)、甲状腺过氧化酶抗体(TPO-Ab)、甲状腺球蛋白抗体(TG-Ab)及血晒水平,记录不良反应发生情况,观察临床治疗效果。结果与本组治疗前比较,两组治疗后T3、T4水平升高,TSH、TPO-Ab、TG-Ab水平均下降,且观察组血硒水平升高,差异有统计学意义(P <0. 05);与对照组比较,观察组治疗后TPO-Ab及TG-Ab水平下降,血硒水平上升,差异有统计学意义(P <0. 05)。观察组、对照组不良反应发生率分别为11. 90%(5/42)、30. 95%(13/42),治疗总有效率分别为92. 86%(39/42)、76. 19%(32/42),差异均有统计学意义(P <0. 05)。结论硒酵母并左甲状腺素钠治疗桥本甲状腺炎伴甲状腺功能减退有效地降低了甲状腺自身抗体水平,未明显影响甲状腺功能,且并发症发生率降低,安全性好。

Objective To observe the effect of selenium yeast-combined with levothyroxine sodium on blood selenium and thyroid autoantibodies in patients with Hashimoto's thyroiditis complicated with hypothyroidism.Methods Eighty-four patients with Hashimoto's thyroiditis complicated with hypothyroidism admitted to our hospital from September2016to September2017were randomly divided into the control group and the observation group,with42cases in each group.Both groups were given levothyroxine sodium orally,and the observation group was given oral selenium yeast on this basis.The course of treatment was3months.Triiodothyronine(T3),thyroxine(T4),thyroid stimulating hormone(TSH),antithyroid peroxidase autoantibody(TPO-Ab),anti-thyroglobulin antibodies(TG-Ab)and blood selenium levels were measured before treatment and3months after treatment.The adverse reactions were recorded and the clinical treatment effect was observed.Results Compared with those before treatment,the levels of T3and T4in the two groups were increased after3months of treatment,whereas the levels of TSH,TPO-Ab and TG-Ab were decreased.Moreover,the blood selenium levels in the observation group were increased,and the difference was statistically significant(P<0.05).Compared with the control group,the levels of TPO-Ab and TG-Ab were decreased while the level of blood selenium was increased in the observation group after3months of treatment(P<0.05).The incidence of adverse reactions in the observation group and the control group were11.90%(5/42)and30.95%(13/42),respectively.The total effective rate of treatment were92.86%(39/42)and76.19%(32/42),respectively,and there were significant differences(P<0.05).Conclusion Selenium yeast-assisted levothyroxine sodium in the treatment of Hashimoto's thyroiditis complicated with hypothyroidism is effective in reducing the level of thyroid autoantibodies,which does not significantly affect thyroid function.In addition,the incidence of complications is reduced,and the safety is good.