硒酵母对慢性淋巴细胞性甲状腺炎甲状腺过氧化物酶抗体滴度的影响

Effect of selenium yeast on thyroid peroxidase antibody titer of chronic lymphocytic thyroiditis

目的评价硒酵母治疗对慢性淋巴细胞性甲状腺炎甲状腺过氧化物酶抗体(TPOAb)滴度的影响。方法150例慢性淋巴细胞性甲状腺炎患者,其中甲状腺功能正常患者78例,甲状腺功能减退患者72例。将甲状腺功能正常患者随机分为A组和B组,各39例。将甲状腺功能减退患者随机分为C组和D组,各36例。排除不符合标准患者,最终A组34例,B组33例,C组26例,D组29例。A组患者未用药治疗;B组采用硒酵母治疗;C组采用左甲状腺素钠片(商品名:优甲乐)治疗;D组采用优甲乐联合硒酵母治疗。比较四组不同时间段临床疗效及TPOAb、促甲状腺激素(TSH)水平。结果治疗6、12、18个月,B组有效率分别为48.48%、75.76%、84.85%,均高于A组的0、0、0,差异具有统计学意义(P<0.05);治疗6、12、18个月,D组有效率为58.62%、89.66%、96.55%,均高于C组的26.92%、50.00%、53.85%,差异具有统计学意义(P<0.05)。治疗6、12、18个月,B组TPOAb水平明显降低,组内比较差异具有统计学意义(P<0.05)。治疗6、12、18个月,B组TPOAb水平低于A组,差异具有统计学意义(P<0.05)。治疗6、12、18个月,C组TSH水平明显降低,组内比较差异具有统计学意义(P<0.05)。治疗6、12、18个月,D组TPOAb、TSH水平明显降低,组内比较差异具有统计学意义(P<0.05)。治疗6、12、18个月,D组TPOAb水平低于C组,差异具有统计学意义(P<0.05)。结论硒酵母可有效干预慢性淋巴细胞性甲状腺炎患者血清TPOAb的水平,对其改变作用是显著且持续的,具有时间依赖性。

Objective To evaluate the effect of selenium yeast on thyroid peroxidase antibody(TPOAb)titer of chronic lymphocytic thyroiditis.Methods There were 150 patients with chronic lymphocytic thyroiditis,including 78 patients with normal thyroid function and 72 patients with hypothyroidism.78 patients with normal thyroid function were randomly divided into group A and group B,with 39 cases in each group,and 72 patients with hypothyroidism were randomly divided into group C and group D,with 36 cases in each group.Excluding patients who did not meet the criteria,finally there were 34 cases in group A,33 cases in group B,26 cases in group C,and 29 cases in group D.Group A was not treated with medication,group B was treated with selenium yeast,group C was treated with levothyroxine sodium tablets(trade name:Euthyrox),group D was treated with Euthyrox combined with selenium yeast.The clinical efficacy,TPOAb and thyroid stimulating hormone(TSH)levels at different time points were compared among the four groups.Results 6,12 and 18 months after treatment,the effective rate of group B was 48.48%,75.76%and 84.85%respectively,which was higher than that of group A 0,0 and 0,and the difference was statistically significant(P<0.05).6,12 and 18 months after treatment,the effective rate of group D was 58.62%,89.66%and 96.55%,which was higher than that of group C 26.92%,50.00%and 53.85%,and the difference was statistically significant(P<0.05).6,12 and 18 months after treatment,TPOAb level of group B was obviously reduced,and the difference was statistically significant(P<0.05).6,12 and 18 months after treatment,TPOAb level of group B was lower than that of group A,and the difference was statistically significant(P<0.05).6,12 and 18 months after treatment,TSH level of group C was obviously reduced,and the difference was statistically significant(P<0.05).6,12 and 18 months after treatment,TPOAb and TSH level of group D was significantly reduced,and the difference was statistically significant(P<0.05).6,12 and 18 months after treatment,TPOAb level of group D was lower than that of group C,and the difference was statistically significant(P<0.05).Conclusion Selenium yeast can effectively intervene in the level of serum TPOAb in patients with chronic lymphocytic thyroiditis,and its changing effect is significant and continuous with time dependence.