补硒治疗对HT患者甲状腺功能、免疫应答及氧化应激的影响

Effects of selenium supplementation on thyroid function,immune response and oxidative stress in HT patients

目的:探讨补硒治疗对甲状腺功能正常的HT患者甲状腺功能、免疫应答及氧化应激的影响。方法:选择我院收治的120例甲状腺功能正常的桥本甲状腺炎患者作为研究对象,随机分为治疗组与对照组,每组各60例。对照组给予口服安慰剂(临床随访);治疗组给予口服硒酵母。观察比较两组甲状腺功能促甲状腺激素(TSH)、游离三碘甲状腺原氨酸(FT3)及游离甲状腺素(FT4)、免疫应答甲状腺过氧化物酶抗体(TPOAb)、甲状腺球蛋白抗体(TGAb)、干扰素-γ(IFN-γ)及白介素-4(IL-4)]及氧化应激包括丙二醛(MDA)、谷胱甘肽过氧化物酶(GPx)、超氧化物歧化酶(SOD)相关指标的表达水平并进行分析。结果:两组研究对象在免疫应答及氧化应激方面变化明显。治疗前,两组患者各项水平无显著差异(P>0.05);治疗后,对照组患者上述相关指标水平与治疗前相比仍无显著差异(P>0.05);治疗组甲状腺功能相关指标水平与治疗前及对照组相比无显著差异(P>0.05),TPOAb、TGAb、IFN-γ及MDA水平与治疗前及对照组相比显著降低(P<0.05),IL-4、GPx及SOD水平与治疗前及对照组相比显著升高(P<0.05)。结论:补硒治疗可稳定HT患者甲状腺功能,降低甲状腺抗体生成水平,并改善免疫应答及氧化应激反应。

Objective:To explore the effect of selenium supplementation on thyroid function,immune response and oxidative stress in HT patients with normal thyroid function.Methods:120 Hashimoto's thyroiditis patients with normal thyroid function admitted to our hospital from June 2016 to March 2018 were randomly divided into treatment group and control group with 60 cases in each group.The control group was given oral placebo,while the treatment group was given selenium yeast.The expression levels of thyroid function including thyroid stimulating hormone(TSH),free triiodothyronine(FT3)and free thyroxine(FT4),immune response including thyroid peroxidase antibody(TPOAb),thyroglobulin antibody(TGAb),interferon-γ(IFN-γ),interleukin-4(IL-4)and oxidative stress including malondialdehyde(MDA),glutathione peroxidase(GPx)and superoxide dismutase(SOD)were observed and compared between the two groups.Results:The two groups showed significant changes in auxiliary diagnosis,immune response and oxidative stress.Before treatment,there was no significant difference in the levels between the two groups(P>0.05).After treatment,there was no significant difference in the above indexes between the control group and that before treatment(P>0.05).There was no significant difference in thyroid function related indexes between the treatment group and the control group(P>0.05).The levels of TPOAb,TGAb,IFN-γ and MDA in the treatment group were significantly lower than those before treatment and in the control group(P<0.05),while the levels of IL-4,GPx and SOD were significantly higher than those before treatment and in the control group(P<0.05).Conclusions:Selenium supplementation can stabilize thyroid function,reduce the level of thyroid antibody production,and improve immune response and oxidative stress response in HT patients.