局部注射曲安奈德联合左甲状腺素钠治疗桥本甲状腺炎的效果

Effect of local injection of Triamcinolone Acetonide combined with Levothyroxine Sodium in the treatment of Hashimoto′s thyroiditis

目的 探讨局部注射曲安奈德联合左甲状腺素钠治疗桥本甲状腺炎的效果。方法 选取2018年5月至2020年5月辽阳市中心医院新城医院收治的120例桥本甲状腺炎患者作为研究对象,采用随机数字表法将其分为对照组与观察组,每组各60例。对照组患者给予左甲状腺素钠治疗,观察组患者在对照组的基础上加用局部注射曲安奈德治疗。比较两组患者连续治疗12周后的疗效、甲状腺指标、血清内脂素、细胞因子表达水平及不良反应发生情况。结果 观察组患者的临床总有效率高于对照组,差异有统计学意义(P<0.05)。观察组患者治疗后的促甲状腺激素(TSH)、甲状腺球蛋白抗体(TGAb)、甲状腺微粒体抗体(TMAb)、血清内脂素、重组分化蛋白簇195(CD195)及重组分化蛋白簇30(CD30)均低于对照组,血清游离三碘甲状腺原氨酸(FT_(3))及血清游离甲状腺素(FT_(4))高于对照组,差异有统计学意义(P<0.05)。两组患者不良反应总发生率比较,差异无统计学意义(P>0.05)。结论 在左甲状腺素钠治疗桥本甲状腺炎的基础上加用局部注射曲安奈德可更好地缓解临床症状及体征,调节甲状腺相关指标,改善血清内脂素及细胞因子表达水平,且治疗期间未见明显的不良反应,安全性有保障。

Objective To explore and analyze the curative effect of local injection of Triamcinolone Acetonide combined with Levothyroxine Sodium in the treatment of Hashimoto′s thyroiditis and its effect on serum visfatin and cytokines.Methods A total of 120 patients with Hashimoto′s thyroiditis were treated in the Xincheng Hospital of Liaoyang Central Hospital selected from May 2018 to May 2020,the patients were divided into the control group and the observation group by random number table method,with 60 cases in each group.Control group was treated with Levothyroxine Sodium,and observation group was treated with local Triamcinolone Acetonide injection on the basis of control group.The efficacy,thyroid indexes,serum lipins and cytokines expression levels and the incidence of adverse reactions were compared between the two groups after 12 weeks of continuous treatment.Results The total clinical effective rate in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).After treatment,the levels of thyroid stimulating hormone(TSH),thyroglobulin antibody(TGAb),thyroid microsomal antibody(TMAb),serum lipin,recombinant differentiated protein cluster 195(CD195)and recombinant differentiated protein cluster 30(CD30)in observation group were lower than those in control group,serum free triiodothyronine(FT_(3))and serum free thyroxine(FT_(4))were higher than those in control group,the differences were statistically significant(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion The addition of local injection of Triamcinolone Acetonide to the treatment of Hashimoto′s thyroiditis by Levothyroxine Sodium can better relieve clinical symptoms and signs,regulate thyroid-related indicators,improve serum visfatin and cytokine expression levels,and no obvious adverse reactions were seen during the treatment,and the safety is guaranteed.