小剂量左甲状腺素治疗良性甲状腺结节的疗效观察  

Small Dose Levothyroxine Suppression Therapy for Benign Thyroid Nodules

作　　者：魏立民[1] 李海英[2] 刘娜[1] 何学峰[1] 章冬梅[1] 吕秀芹[1] 李萍[1] 

机构地区：[1]河北省人民医院内分泌科,河北省石家庄市050051 [2]石家庄市第四医院

出　　处：《中国全科医学》2013年第20期2404-2406,共3页Chinese General Practice

摘　　要：目的观察小剂量左甲状腺素治疗良性甲状腺结节的疗效。方法选择2009年7月—2011年9月在我院就诊的良性甲状腺结节患者共134例,给予小剂量左甲状腺激素(25μg,1次/d)维持治疗1年,观察其治疗前后实验室检查指标和甲状腺结节大小变化,并进行亚组分析,记录患者对药物治疗的满意度。结果本组134例患者治疗前后体质指数(BMI)及总甲状腺素(TT4)、总三碘甲状腺原氨酸(TT3)、抗甲状腺过氧化物酶抗体(TPO-Ab)、三酰甘油(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)水平比较,差异均无统计学意义(P>0.05);促甲状腺激素(TSH)、总胆固醇(TC)水平比较,差异均有统计学意义(P<0.05)。治疗前结节大小为(1.69±0.47)cm,治疗后为(1.35±0.38)cm,差异有统计学意义(t=6.83,P<0.01)。治疗前,不同年龄、TPO-Ab水平患者结节大小比较,差异均无统计学意义(P>0.05);不同结节直径、结节性质、TSH水平患者结节大小比较,差异均有统计学意义(P<0.05)。治疗后,不同年龄、结节直径、结节性质、TSH水平患者结节大小比较,差异均有统计学意义(P<0.05);不同TPO-Ab水平患者结节大小比较,差异无统计学意义(P>0.05)。患者满意率为85.82%(115/134)。结论小剂量左甲状腺素治疗良性甲状腺结节安全有效,且有一定的降低血脂作用,主要适用于年轻、实性结节及TSH水平增高者。Objective To study the efficacy of small dose levothyroxine in the management of benign thyroid nodules in different groups of subjects.Methods A total of 134 patients who visited our hospital and diagnosed with benign thyroid nodules between July 2009 and September 2011 were included in the study.All patients were treated with small dose levothyroxine（25 μg,1/d） for 1 year.The laboratory test results and thyroid nodule size were measured before and after treatment.Furthermore,subgroup analyses were also conducted,and patients＇degree of satisfaction about the treatment was recorded.Results Significant difference before and after the treatment was not observed in BMI,total thyroxine,total triiodothyronine,anti-thyroid peroxidase antibody（TPO-Ab）,triglyceride,high-density lipoprotein,and low-density lipoprotein（P〈 0.05）,but observed in thyroid stimulating hormone（TSH）,and total cholesterol（P〈 0.05）.Nodule size after the treatment 〔（1.35 ± 0.28） cm〕was smaller than that before the treatment 〔（1.66 ± 0.37） cm,t = 6.83,P〈 0.01〕.Before the treatment,significant difference was not observed in nodule size among different age groups and in patients with different TPO-Ab levels（P〈 0.05）,but observed among patients with different nodule diameter,nodule nature,and TSH level（P〈 0.05）.After the treatment,significant difference was observed in nodule size among different age groups,patients with different nodule diameter,nature,and TSH level（P〈 0.05）,but not observed in patients with different TPO-Ab levels（P〈 0.05）.About 85.82%（115/134） of the patients were satisfied with the treatment effects.Conclusion Small dose levothyroxine suppression therapy is safe and effective in treating benign thyroid nodule and has certain effect in reducing blood fat level,especially in young patients with solid nodule and high level of TSH.

关 键 词：甲状腺结节 甲状腺素 治疗结果 细胞学技术 

分 类 号：R581.33[医药卫生—内分泌]