左甲状腺素钠联合补硒治疗甲状腺功能减退疗效及对甲状腺功能的影响

Effect of Levothyroxine Sodium Combined with Selenium Supplementation on Hypothyroidism and Thyroid Function

目的 分析左甲状腺素钠联合补硒治疗甲状腺功能减退疗效及对甲状腺功能的影响。方法 方便选取宜兴市人民医院2019年3月—2021年3月内分泌科门诊的86例甲状腺功能减退患者为研究对象,采用随机数表法分为常规组(43例,常规左甲状腺素钠治疗)和观察组(43例,左甲状腺素钠联合补硒治疗)。对比两组患者入院时与治疗16周后的甲状腺功能指标[促甲状腺激素(TSH)、游离三碘甲状腺原氨酸(FT_(3))、游离甲状腺素(FT_(4))]、抗体指标[甲状腺过氧化物酶抗体(TPO-Ab)、甲状腺球蛋白抗体(TG-Ab)]及不良反应发生率。结果 治疗前,两组患者的甲状腺功能指标及抗体指标比较,差异无统计学意义(P>0.05)。治疗后,观察组患者FT_(3)(4.02±0.56)pg/mL、FT_(4)(1.79±0.17)ng/dl显著高于常规组,差异有统计学意义(t=7.487、25.681,P<0.05);观察组TSH与抗体指标及不良反应发生率显著低于常规组,差异有统计学意义(P<0.05)。结论 对甲状腺功能减退患者给予左甲状腺素钠与补硒的联合治疗,可有效促进患者甲状腺功能恢复,且不良反应发生率较低,疗效显著,安全高效。

Objective To analyze the effects of levothyroxine sodium combined with selenium supplementation on hypothyroidism and thyroid function.Methods A total of 86 hypothyroidism patients in Endocrinology Department of Yixing People´s Hospital from March 2019 to March 2021 were conveniently selected as the research objects.They were divided into conventional group(43 cases,conventional levothyroxine sodium treatment)and observation group(43 cases,levothyroxine sodium combined with selenium treatment)by random number table method.The thyroid function indexes[thyroid stimulating hormone(TSH),free triiodothyronine(FT3),free thyroxine(FT4)],antibody indexes[thyroid peroxidase antibody(TPO-Ab),thyroglobulin antibody(TG-Ab)]and the incidence of adverse reactions were compared between the two groups at admission and 16 weeks after treatment.Results Before treatment,there was no statistical significance in thyroid function indexes and antibody indexes between 2 groups(P>0.05).After treatment,FT3(4.02±0.56)pg/mL and FT4(1.79±0.17)ng/dl in observation group were significantly higher than those in conventional group,and the difference was statistically significant(t=7.487,25.681,P<0.05).The incidence of TSH and antibody indexes and adverse reactions in the observation group were significantly lower than those in the conventional group,and the difference was statistically significant(P<0.05).Conclusion The combined treatment of levothyroxine sodium and selenium supplementation in hypothyroidism patients can effectively promote the recovery of thyroid function,and the incidence of adverse reactions is low,the efficacy is significant,safe and efficient.