老年亚临床甲减患者应用不同剂量左甲状腺素钠片治疗对其脂代谢水平的影响观察

Effect of Different Doses of Levothyroxine Sodium Tablets on Lipid Metabolism in Elderly Patients with Subclinical Hypothyroidism

目的:探讨老年亚临床甲减患者应用不同剂量左甲状腺素钠片治疗对其脂代谢水平的影响。方法:选取某院2018年12月~2020年12月65例老年亚临床甲患者,根据随机数字表法分为A例(n=33)和B组(n=32)。均在进行常规治疗的基础上,A组根据血清中促甲状腺素(TSH)水平变化调节左旋甲状腺素钠片的剂量,B组每日给予25μg左旋甲状腺素钠片,疗程10周。检测两组患者的血脂指标及甲状腺激素水平变化,比较两组的治疗效果和治疗过程中不良反应的发生情况。结果:A组总有效率显著高于B组(P<0.05);A组治疗后游离三碘甲状腺原氨酸(FT3)、游离甲状腺激素(FT4)高于B组,TSH低于B组(P<0.05);A组治疗后胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、甘油三酯(TG)低于B组,高密度脂蛋白胆固醇(HDL-C)高于B组(P<0.05);A组总不良反应发生率低于B组(P<0.05)。结论:依照血清中促甲状腺素水平变化情况调节患者服用的左甲状腺素钠片剂量对于老年亚临床甲减有显著疗效,能明显调节患者的脂代谢水平,降低不良反应的发生,效果优于服用固定剂量左旋甲状腺素钠片。

Objective:To investigate the effect of different doses of levothyroxine sodium tablets on lipid metabolism in elderly patients with subclinical hypothyroidism.Methods:From December 2018 to December 2020,65 elderly patients with subclinical hypothyroidism were selected and randomly divided into group A(n=33)and group B(n=32).On the basis of routine treatment,group A adjusted the dosage of levothyroxine sodium tablets according to the change of serum TSH level,while group B was given 25μg levothyroxine sodium tablets daily for 10 weeks.The blood lipid index and thyroid hormone level of the two groups were detected,and the treatment effect and the incidence of adverse reactions were compared.Results:The total efficiency in the group A was significantly higher than that in the group B(P<0.05).After treatment,The FT3 and FT4 in the group A were higher than those in the group B,and the TSH was lower than that in the group B(P<0.05).After treatment,the blood cholesterol(TC),low density lipoprotein(LDL-C),and triglyceride(TG)in the group A were lower than those in the group B,and the high density lipoprotein(HDL-C)of the group A was higher than that in the group B(P<0.05).The incidence of adverse reactions of group A was lower than that of group B(P<0.05).Conclusion:Adjusting the dosage of levothyroxine sodium tablets according to the change of serum thyrotropin level has a significant effect on elderly patients with subclinical hypothyroidism.It can significantly regulate the level of lipid metabolism and reduce the incidence of adverse reactions.The effect is better than taking fixed dose levothyroxine sodium tablets.