甲状腺素钠联合地塞米松对桥本甲状腺炎的临床疗效观察

Clinical efficacy of thyroxine sodium combined with dexamethasone on Hashimoto's thyroiditis

目的探讨甲状腺素钠联合地塞米松磷酸钠治疗桥本甲状腺炎(Hashimotos's thyroiditis,HT)的疗效。方法选取2020年2月至2023年2月齐齐哈尔市第一医院、齐齐哈尔医学院附属第三医院和齐齐哈尔市精神卫生中心的HT患者82例,根据随机数字表法随机分为对照组与研究组,每组41例。对照组予以甲状腺素钠治疗,研究组在对照组基础上联合地塞米松磷酸钠治疗。比较治疗后两组治疗效果,细胞因子、甲状腺相关激素和血清甲状腺过氧化物酶抗体(thyroid peroxidase antibody,TPOAb)、甲状腺球蛋白抗体(thyroglobulin antibody,TgAb)的水平及不良反应的差异。结果82例患者中男23例、女59例,年龄22~65岁,平均(43.6±7.9)岁。治疗后,与对照组相比,研究组的治疗有效率较高(90.24%比63.41%),IL-4较高([191.24±35.13)ng/L比(176.03±30.59)ng/L]、IL-10较高([17.11±3.26)ng/L比(15.72±2.81)ng/L]、IL-13较高([94.53±16.72)ng/L比(82.61±14.65)ng/L]、FT3较高([4.73±0.81)pmol/L比(4.27±0.76)pmol/L]、FT4较高([10.48±1.75)pmol/L比(9.33±1.52)pmol/L],IL-2较低([7.59±1.26)μg/L比(8.45±1.43)μg/L]、IFN-γ较低([143.15±26.91)ng/L比(169.27±29.46)ng/L]、TSH较低([6.94±1.17)mU/L比(8.75±1.44)mU/L]、TPOAb较低([29.56±5.12)U/ml比(40.33±7.58)U/ml]、TgAb较低([65.24±10.75)U/ml比(89.58±16.43)U/ml],差异均有统计学意义(P<0.05)。两组不良反应发生率的差异无统计学意义(P>0.05)。结论甲状腺素钠联合地塞米松磷酸钠能够明显提高HT患者的临床疗效、维持细胞因子平衡,并改善甲状腺激素与甲状腺抗体水平。

Objective To explore the curative effect of thyroxine sodium combined with dexamethasone sodium phosphate on Hashimoto's thyroiditis(HT).Methods A total of 82 HT patients admitted to The First Hospital of Qiqihar,The Third Affiliated Hospital of Qiqihar Medical College and Qiqihar Mental Health Center from February 2020 to February 2023 were selected,and were randomly divided into control group and study group according to the random number table method,with 41 cases in each group.The control group was treated with thyroxine sodium,while the study group was treated with dexamethasone sodium phosphate on the basis of the control group.The therapeutic effect,the levels of cytokines,thyroid-related hormones,serum thyroid peroxidase antibody(TPOAb),thyroglobulin antibody(TgAb)and adverse reactions were compared between the two groups after treatment.Results Among the 82 patients,there were 23 males and 59 females,aged from 22 to 65 years,with an average age of(43.6±7.9)years old.After treatment,the effective rate(90.24%vs.63.41%),the levels of IL-4[(191.24±35.13)ng/L vs.(176.03±30.59)ng/L],IL-10[(17.11±3.26)ng/L vs.(15.72±2.81)ng/L],IL-13[(94.53±16.72)ng/L vs.(82.61±14.65)ng/L],FT3[(4.73±0.81)pmol/L vs.(4.27±0.76)pmol/L]and FT4[(10.48±1.75)pmol/L vs.(9.33±1.52)pmol/L]were higher,while the levels of IL-2[(7.59±1.26)μg/L vs.(8.45±1.43)μg/L],IFN-γ[(143.15±26.91)ng/L vs.(169.27±29.46)ng/L],TSH[(6.94±1.17)mU/L vs.(8.75±1.44)mU/L],TPOAb[(29.56±5.12)U/ml vs.(40.33±7.58)U/ml]and TgAb[(65.24±10.75)U/ml vs.(89.58±16.43)U/ml]were lower in the study group than those in the control group,and the differrences were statistically significant(all P<0.05).There were no significant differences in the occurrence of adverse reactions between the two groups(P>0.05).Conclusions Thyroxine sodium combined with dexamethasone sodium phosphate can obviously improve the clinical efficacy for HT patients,and improve the levels of thyroid hormones and thyroid antibodies.