左甲状腺素钠在老年甲状腺功能减退综合征治疗中的应用

Clinical effect and safety of levothyroxine sodium in the treatment of senile hypothyroidism syndrome

目的评估左甲状腺素钠治疗老年甲状腺功能减退综合征(简称“甲减综合征”)的疗效及其安全性。方法将杨凌示范区医院内分泌科2018年1月至2019年12月收治的200例甲减综合征老年患者纳入研究,按照随机双盲的原则分为对照组和观察组,每组100例。对照组患者全程接受甲状腺片治疗,观察组患者则采用左甲状腺素钠治疗,所有患者均接受14 d治疗。检测并比较两组患者治疗前后的促甲状腺激素(TSH)、血清游离甲状腺素(FT4)及血清游离三碘甲状腺原氨酸(FT3)水平,并比较两组患者的治疗效果及不良反应发生情况。结果治疗后,观察组患者的TSH水平为(3.2±1.1)mIU/L,明显低于对照组的(6.8±1.5)mIU/L,FT4、FT3水平分别为(11.2±1.2)pmol/L和(4.6±1.8)pmol/L,明显高于对照组的(6.8±1.8)pmol/L和(3.2±1.3)pmol/L,差异均有统计学意义(P<0.05);观察组患者的治疗总有效率为90.0%,明显高于对照组的64.0%,差异有统计学意义(P<0.05);观察组患者的不良反应发生率为4.0%,明显低于对照组的18.0%,差异有统计学意义(P<0.05)。结论左甲状腺素钠治疗老年甲减综合征效果良好,且具有较高的安全性,具有较高的临床应用价值。

Objective To explore the therapeutic effect and safety of levothyroxine sodium in the treatment of elderly hypothyroidism syndrome.Methods A total of 200 elderly patients with hypothyroidism who were admitted to the Department of Endocrinology,Yangling Demonstration District Hospital from January 2018 to December 2019 were included in the study.They were divided into a control group and an observation group according to the principle of ran-dom and double-blind,with 100 patients in each group.Patients in the control group received thyroid tablets for the en-tire treatment,and patients in the observation group were treated with levothyroxine sodium,all for 14 days.The levels of thyroid-stimulating hormone(TSH),serum free thyroxine(FT4),and serum free triiodothyronine(FT3)before and after treatment in the two groups were detected and compared,as well as the patient's treatment effect and the occurrence of ad-verse reactions.Results Compared with the control group,the TSH level in the observation group was(3.2±1.1)mIU/L,significantly lower than(6.8±1.5)mIU/L of the control group(P<0.05).The levels of FT4 and FT3 were(11.2±1.2)pmol/L and(4.6±1.8)pmol/L in the observation group,significantly higher than(6.8±1.8)pmol/L and(3.2±1.3)pmol/L in the con-trol group(P<0.05).The total effective rate of treatment in the observation group was 90.0%,which was significantly lower than 64.0%in the control group(P<0.05).The incidence of adverse reactions in the observation group was 4.0%,significantly lower than 18.0%in the control group(P<0.05).Conclusion The application of levo-thyroxine sodium in the treatment of elderly hypothyroidism syndrome has a good therapeutic effect,and has high safety and high application value.