硒酵母片联合左甲状腺素钠片治疗桥本甲状腺炎并甲状腺功能减退患者的临床效果

Clinical Efficacy of Levothyroxine Combined with Selenium Yeast in the Treatment of Hashimotos Thyroiditis with Hypothyroidism

目的观察硒酵母片联合左甲状腺素钠片治疗桥本甲状腺炎(HT)并甲状腺功能减退患者的临床效果。方法将郑州人民医院2019年9月至2020年4月收治的80例甲状腺功能减退患者以抽签法随机分为对照组及研究组,每组40例。对照组接受左甲状腺素钠片治疗,研究组接受硒酵母片联合左甲状腺素钠片治疗,治疗6个月后分析两组患者的临床疗效及甲状腺自身免疫抗体滴度的变化。结果对照组患者的治疗总有效率为82.50%,研究组患者治疗总有效率为85.00%,差异无统计学意义(P>0.05)。治疗前两组游离三碘甲状腺原氨酸(FT_(3))、游离甲状腺素(FT_(4))、促甲状腺素(TSH)、甲状腺过氧化物酶抗体(TPOAb)、甲状腺球蛋白抗体(TGAb)比较,差异无统计学意义(P>0.05);治疗后两组患者FT_(3)、FT_(4)较治疗前均上升,TSH较治疗前下降(P<0.05),但两组FT_(3)、FT_(4)比较,差异无统计学意义(P>0.05)。对照组TPOAb、TGAb治疗前及治疗后未见明显变化,研究组患者TPOAb、TGAb治疗后较治疗前降低(P<0.05)。对照组患者不良反应的发生率仅为7.50%,研究组患者不良反应发生率为5.00%,组间对比差异无统计学意义(P>0.05)。结论硒酵母片联合左甲状腺素钠片治疗HT并甲状腺功能减退患者,能明显降低TPOAb和TGAb滴度,提示硒制剂具有一定的免疫调节作用。

Objective To investigate the clinical efficacy of levothyroxine combined with selenium yeast in the treatment of Hashimotos thyroiditis(HT)with hypothyroidism.Methods A total of 80 HT patients with hypothyroidism in Zhengzhou People’s Hospital from September 2019 to April 2020 were randomly divided into study group and control group by drawing lots,and with 40 cases in each group.The control group was treated with levothyroxine alone,and the study group was treated with levothyroxine combined with selenium yeast.After 6 months’treatment,the clinical efficacy was determined and the titer of thyroid autoimmune antibodies was tested.Results The total effective rate of the control group was 82.50%,and that of the study group was 85.00%,and there was no difference between the two groups(P>0.05).Before treatment,there were no differences in the level changes of free triiodothyronine(FT_(3)),free thyroxine(FT_(4)),thyroid-stimulating hormone(TSH),thyroglobulin antibody(TGAb),thyroid peroxidase antibody(TPOAb)between the two groups(P>0.05).After treatment,FT_(3) and FT_(4) of the two groups were increased and TSH was decreased(P<0.05),but there was no difference between the two groups(P>0.05).There were no differences of TPOAb and TGAb before and after treatment in the control group,but the level changes in the study group were decreased(P<0.05).The incidence of adverse reactions in the control group was 7.50%,and that in the study group was 5.00%,and there was no difference between the two groups(P>0.05).Conclusion Levothyroxine combined with selenium yeast in the treatment of HT with hypothyroidism could effectively decrease the level of TPOAb and TGAb,which indicated that selenium may have an immunomodulatory effect.