硒酵母联合左甲状腺素对甲状腺功能减退患者甲状腺功能及预后的影响

摘要

Objective To investigate the improvement of thyroid function and the prognosis of patients with thyroid dysfunction after treatment with selenium yeast combined with levothyroxine,and to provide a basis for clinical diagnosis and treatment of the dis-ease.Methods 94 patients with hypothyroidism were divided into control group and observation group.The control group was trea-ted with levothyroxine alone.The observation group was orally treated with levothyroxine and selenium yeast tablets.The 2 groups of patients were compared.Results After treatment,for the observation group,the level of TSH was 4.4 ± 1.2 mU·L -1,TPO-Ab level was 206.4 ± 35.6 IU·L -1,TGAb level was 60.0 ± 17.5 IU·L -1,which were significantly lower than that of the con-trol group(P<0.05).The FT4level was 17.2 ± 3.1 nmol·L -1and FT3level was 5.4 ± 1.7 nmol·L -1,which were significantly higher than the control group(P<0.05).Adverse reactions occurred in 3 cases in the observation group and 13 cases in the con-trol group(P<0.05).The scores of the observation group were 76.2 ± 8.2,the sensory function score was 78.7 ± 7.8,the emo-tion function score was 71.7 ± 7.1,the social function score was 78.5 ± 8.2,and the patients quality of life scores were significant-ly higher than the control group(P<0.05).Conclusion For the patients with thyroid dysfunction,the treatment of levothyroxine combined with selenium yeast tablets can improve the thyroid function significantly,and the treatment is safe,effective,fewer ad-verse reactions with good prognosis.%目的 探究甲状腺功能减退患者采用硒酵母片联合左甲状腺素进行治疗后,患者的甲状腺功能改善情况以及预后,为该疾病患者的临床诊治提供依据.方法 选择甲状腺功能减退患者94例,均分为对照组和观察组,各47例,对照组仅采用左甲状腺素治疗,观察组则在左甲状腺素治疗的基础上口服硒酵母片,分析2组患者治疗情况.结果 治疗后,观察组促甲状腺激素(TSH)水平为4.4 ± 1.2 mU · L -1,甲状腺过氧化物酶抗体(TPOAb)水平为206.4 ± 35.6 IU·mL -1,甲状腺球蛋白抗体(TGAb)水平为60.6 ± 17.5 IU·mL -1,三者明显低于对照组(P<0.05);而游离四碘甲状腺原氨基酸(FT4)水平为17.2 ± 3.1 nmol·L -1,游离三碘甲状腺原氨基酸(FT3)水平为5.4 ± 1.7 nmol·L -1,二者明显高于对照组(P<0.05);2组数据差异具有统计学意义(P<0.05).观察组3例出现不良反应,对照组13例出现不良反应(P<0.05).观察组生理功能评分为76.2 ± 8.2分,感知功能评分为78.7±7.8分,情绪功能评分为71.7±7.1分,社会功能评分为78.5±8.2分,患者各项生活质量评分指标均明显高于对照组(P<0.05).结论 甲状腺功能减退患者在采用左甲状腺素治疗的基础上联合硒酵母片治疗后,患者的甲状腺功能得到明显改善,且该治疗方法安全有效、患者不良反应较少、预后良好.