目的：观察骨化三醇在桥本甲状腺炎（ HT）并甲状腺功能减退患者中的临床疗效。方法选取2014年3～9月浙江大学附属第一医院明确诊断为 HT并甲状腺功能减退的48例患者为研究对象。根据25－羟维生素D3[25－（ OH ） D3]低于正常水平下线分为正常组（12例）及低水平组（36例）。将其低水平组依据随机数字表法分为 A、B 组，各18例，A 组只服用左甲状腺素，每次50μg，每日1次，连续用药6个月；B组在此基础上加用骨化三醇软胶囊，每次0．25μg，每日1次，连续用药6个月。用药6个月后，观察患者血清25－（ OH） D3和自身抗体及甲状腺功能指标的变化。结果治疗后，B组25－（OH）D3高于A组[（47±5）μg／L比（36±4）μg／L]，甲状腺过氧化物酶抗体、甲状腺球蛋白抗体低于A组[（206±79） kU／L比（325±107） kU／L，（720±106） kU／L比（810±106） kU／L]，差异有统计学意义（P＜0．05）。结论 HT并甲状腺功能减退患者中存在25－（OH）D3水平降低，骨化三醇辅助左甲状腺素治疗HT并甲状腺功能减退有助于降低自身抗体水平，改善其免疫紊乱，可以用于HT的辅助治疗。%Objective To explore and the clinical efficacy of calcitriol for patients of Hashimoto thyroid-itis(HT) with hypothyroidism.Methods Total of 48 patients of HT with hypothyroidism admitted to Shang-hai Jiaotong University School of Medicine Affiliated Xinhua Hospital from Mar.2014 to Sep.2014 were included in the study and divided into two groups by the level of 25-(OH)D3.The low level group was further divided into group A,B,and group A was only given levothyroxine, 50μg per time,once a day,continuously for six months;group B was added with calcitriol soft capsules,0.25 μg per time,once daily,continuously for six months.The serum 25-(OH) D3,auto-antibodies and the thyroid function before and after treatment were observed after six months of treatment.Results After treatment, 25-(OH)D3 of group B was higher than group A [(47 ±5) μg/L vs (36 ±4) μg/L], thyroid peroxidase antibody,thyroglobulin antibody were lower than group A[(206 ±79) kU/L vs (325 ±107) kU/L,(720 ±106) kU/L vs (810 ±106) kU/L], the differences were statistically significant(P<0.05).Conclusion Serum 25-(OH)D3 levels of patients of HT with hypothyroidism are significantly lower ,and calcitriol is demonstrated to helpful as assisted treatment to levothyroxine for the patients to lower autoantibody level and improve the immune disorder .
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