甲状腺素钠片与硒酵母联合治疗桥本甲状腺炎合并甲减的疗效观察

Efficacy of levothyroxine sodium tablets combined with selenium yeast in the treatment of Hashimoto's thyroiditis with hypothyroidism

目的探讨甲状腺素钠片与硒酵母联合治疗桥本甲状腺炎(Hashimoto's thyroiditis,HT)合并甲减的疗效。方法选择2020年10月至2021年12月本院收治的HT合并甲减患者102例作为研究对象,随机分为对照组和联合组各51例。对照组给予甲状腺素钠片,联合组给予甲状腺素钠片+硒酵母。比较两组临床疗效、甲状腺功能、血硒水平、自身抗体水平、免疫功能以及不良反应发生情况。结果联合组总有效率高于对照组,差异有统计学意义(P<0.05);治疗后,两组FT_(3)、FT_(4)升高(P<0.05),TSH下降,血硒水平升高,TPO-Ab、TG-Ab下降,CD3^(+)、CD8^(+)升高,CD4^(+)、CD4^(+)/CD8^(+)下降,且两组比较,差异均有统计学意义(P<0.05);两组治疗期间均未见明显不良反应发生。结论甲状腺素钠片与硒酵母联合治疗HT合并甲减安全有效,可明显改善甲状腺功能,值得临床使用。

Objective To explore the efficacy of combination of levothyroxine sodium tablets and selenium yeast in the treatment of Hashimoto's thyroiditis(HT)with hypothyroidism.Methods A total of 102 patients with HT complicated with hypothyroidism who were treated in our hospital from October 2020 to December 2021 were selected as the research subjects,and they were randomly divided into the control group and the combined group,with 51 cases in each group.The control group was treated with levothyroxine sodium tablets,while the combined group was given levothyroxine sodium tablets+selenium yeast.The clinical efficacy,thyroid function,blood selenium level,levels of autoantibodies,immune function and occurrence of adverse reactions were compared between the two groups.Results The total effective rate of the combined group was higher than that of the control group(P<0.05).After treatment,the levels of FT_(3)and FT_(4)in the two groups were increased,the level of TSH was decreased,the blood selenium level was enhanced,TPO-Ab and TG-Ab levels were reduced,CD3^(+)and CD8^(+)were elevated,CD4^(+)and CD4^(+)/CD8^(+)were declined,and the indicators in the combined group were significantly different from those in the control group after treatment(all P<0.05).No obvious adverse reactions occurred in the two groups during treatment.Conclusion The combination of levothyroxine sodium tablets and selenium yeast is safe and effective in the treatment of HT with hypothyroidism,and it can significantly improve the thyroid function and is worthy of clinical application.