左甲状腺素联合小剂量地塞米松治疗老年甲状腺功能减退的效果观察及对患者甲状腺功能、脂代谢的影响

Effectiveness of Levothyroxine Sodium Combined with Small-dose Dexamethasone in Treatment of Elderly Patients with Hypothyroidism and Its Effects on Thyroid Function and Lipid Metabolism

目的评估左甲状腺素联合小剂量地塞米松对老年甲状腺功能减退患者的效果及对患者甲状腺功能、脂代谢的影响。方法选取2018年6月—2019年12月在本院就诊的老年甲状腺功能减退患者80例,根据治疗方法的不同分为观察组和对照组,每组40例。对照组采用左甲状腺素口服治疗,观察组采用左甲状腺素联合小剂量地塞米松口服治疗。2组观察周期为3个月。比较2组临床疗效,治疗前后游离甲状腺素(FT_(4))、游离三碘甲状腺原氨酸(FT_(3))、促甲状腺激素(TSH)和总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)水平,以及不良反应发生情况。结果观察组治疗后总有效率明显高于对照组(P<0.05)。治疗后,2组FT_(3)、FT_(4)升高,TSH降低,且治疗后观察组FT_(3)、FT_(4)高于对照组,TSH低于对照组,差异有统计学意义(P<0.01)。治疗后观察组TC、TG、LDL-C均较治疗前明显下降,且观察组治疗后上述指标降低程度明显大于对照组,差异有统计学意义(P<0.01)。观察组治疗期间不良反应发生率比较差异无统计学意义(P>0.05)。结论左甲状腺素联合小剂量地塞米松能显著提高老年甲状腺功能减退患者的临床疗效,并可改善甲状腺功能及脂代谢水平,且安全性较好。

Objective To evaluate effectiveness of Levothyroxine Sodium combined with small-dose Dexamethasone in treatment of elderly patients with hypothyroidism and its effects on thyroid function and lipid metabolism.Methods A total of 80 elderly patients with hypothyroidism treated during June 2018 and December 2019 were selected and randomly divided into observation group(n=40)and control group(n=40)according to different treatment methods.Control group was treated with Levothyroxine Sodium orally,while observation group was treated with Levothyroxine Sodium and small-dose Dexamethasone orally.The observation period was 3 months in two groups.Clinical efficacy,levels of free thyroxine(FT_(4)),free triiodothyronine(FT_(3)),thyroid stimulating hormone(TSH),total cholesterol(TC),triglyceride(TG)and low-density lipoprotein cholesterol(LDL-C)before and after treatment,and incidence rate of adverse reactions were compared between two groups.Results The total effective rate in observation group was significantly higher than that in control group(P<0.05).After treatment,levels of FT_(3) and FT_(4) were significantly increased,while TSH levels were significantly decreased in two groups;in observation group,FT_(3) and FT_(4) levels were significantly higher than those in control group,while TSH level was significantly lower than that in control group after treatment(P<0.01).After treatment,levels of TC,TG and LDL-C were significantly decreased compared with those before treatment in observation group,and reduction degrees of the above indexes in observation group were significantly greater than those in control group(P<0.01).There was no significant difference in incidence rate of adverse reactions between two groups(P>0.05).Conclusion Levothyroxine Sodium combined with small-dose Dexamethasone may effectively improve clinical efficacy,ameliorate thyroid function and lipid metabolism with good safety in treatment of elderly patients with hypothyroidism.