地塞米松联合甲巯咪唑治疗自身免疫性甲状腺炎效果及对T细胞免疫功能、炎性因子影响观察

Effect of Dexamethasone Combined with Methimazole in the Treatment of Autoimmune Thyroiditis and Its Effect on T Cell Immune Function and Inflammatory Factors

目的观察地塞米松联合甲巯咪唑治疗自身免疫性甲状腺炎的效果及对T细胞免疫功能、炎性因子的影响。方法选取自身免疫性甲状腺炎79例,根据治疗方法不同将其分为观察组(41例)和对照组(38例)两组。观察组予地塞米松磷酸钠注射液联合甲巯咪唑片治疗,对照组予甲巯咪唑片治疗,疗程均为1个月。观察比较两组治疗后临床效果,治疗前后血清甲状腺功能相关指标、T细胞免疫功能相关指标和炎性因子水平,以及治疗期间不良反应发生情况。结果治疗后,观察组总有效率为90.24%高于对照组总有效率71.05%,差异有统计学意义(P<0.05)。治疗前,两组血清甲状腺功能相关指标、T细胞免疫功能相关指标和炎性因子水平比较差异均无统计学意义(P>0.05)。治疗后,血清游离三碘甲状腺原氨酸、甲状腺过氧化物酶抗体、甲状腺球蛋白抗体和肿瘤坏死因子-α、白细胞介素-17水平两组均较治疗前降低,且观察组低于对照组;两组血清CD4+水平及CD4+/CD8+值较治疗前升高,血清CD8+水平较治疗前降低,观察组血清CD4+水平及CD4+/CD8+值高于对照组,血清CD8+水平低于对照组,差异均有统计学意义(P<0.05或P<0.01)。治疗期间,观察组不良反应总发生率为34.15%高于对照组不良反应总发生率28.95%,但两组比较差异无统计学意义(P>0.05)。结论地塞米松联合甲巯咪唑治疗自身免疫性甲状腺炎可提高临床效果,降低自身抗体水平,改善机体免疫功能,减轻炎症反应程度,且安全性良好。

Objective To observe the effect of Dexamethasone combined with Methimazole in the treatment of autoimmune thyroiditis and its influence on T cell immune function and inflammatory factors.Methods Seventy-nine cases of autoimmune thyroiditis were selected and divided into observation group(n=41)and control group(n=38)according to different treatment methods.The control group was only treated with Methimazole orally,while the observation group was supplemented with Dexamethasone sodium phosphate injection combined with Methi mazole orally.The course of treatment was 1 month.The clinical effects of the two groups were observed,and serum thyroid function related indicators,T cell immune function-related indicators and inflammatory factor levels before and after treatment,and the incidence of adverse reactions during the treatment were observed and compared.Results After treatment,the total effective rate of the observation group was 90.24%,which was higher than 71.05%of the control group(P<0.05).Before treatment,no significant difference was found in serum thyroid function related indicators,T cell immune function-related indicators and inflammatory factor levels(P>0.05).After treatment,serum free triiodothyronine,thyroid peroxidase antibody,thyroglobulin antibody,tumor necrosis factor-α,and interleukin-17 levels in the two groups were lower than those before treatment,and the indicators were lower in the observation group than in the control group.After treatment,the levels of CD4+and CD4+/CD8+were increased while CD8+was decreased in the two groups;the levels of CD4+and CD4+/CD8+were significantly higher,but CD8+was significantly lower in the observation group than in the control group(P<0.05 or P<0.01).During the treatment period,the total incidence of adverse reactions in the observation group was 34.15%,which was higher than that in the control group(28.95%),but the difference between the two groups was not statistically significant(P>0.05).Conclusion In the treatment of autoimmune thyroiditis,Dexamethasone combined with Methimazole can significantly improve the curative effect,reduce the level of autoantibodies,improve the immune function of the body,and reduce the degree of inflammatory reaction,and the treatment safety is good.