硒辅助治疗Graves病伴轻度突眼的临床疗效  

Clinical observation of selenium adjuvant therapy for Graves disease with mild exophthalmos

作　　者：肖新怀[1] 陈澍[2] 苏丽芳[3] 

机构地区：[1]广州医科大学附属第二医院老年科,广东广州510260 [2]广州医科大学附属第二医院内分泌科,广东广州510260 [3]广州医科大学附属第二医院放射科,广东广州510260

出　　处：《中国现代医学杂志》2017年第11期91-94,共4页China Journal of Modern Medicine

摘　　要：目的探讨硒联合甲巯咪唑对格雷夫斯病(Graves)病伴轻度突眼患者甲状腺功能、眼球突出度、甲状腺自身抗体及细胞因子的作用。方法选取Graves病伴轻度突眼患者共65例,随机分为对照组、观察组。对照组(30例)口服甲巯咪唑15~30 mg/d,观察组(35例)口服甲巯咪唑15~30 mg/d和硒酵母片100μg,2次/d。分别检测治疗前及治疗后6个月血清甲状腺激素(FT3、FT4)水平、促甲状腺激素(TSH)水平、眼球突出度变化、甲状腺自身抗体(TPOAb、TRAb、TGAb、IgG、IgA和IgM)及细胞因子(IL-2、IL-6)水平。结果治疗6个月后,两组患者FT_3、FT_4、眼球突出度水平、TGAb、TRAb、IgG及IgA水平均较治疗前降低,差异有统计学意义(P<0.05)。TSH水平升高,差异有统计学意义(P<0.05)。两组TPOAb、IgM、IL-6水平亦较治疗前降低(P<0.05),但治疗后两组比较差异无统计学意义(P>0.05)。IL-2水平升高(P<0.05),但治疗后两组比较差异无统计学意义(P>0.05)。结论硒在Graves病及Graves眼病患者中具有抗炎作用,硒辅助治疗Graves病伴轻度突眼具有一定的疗效,值得临床推广应用。Objective To observe the effect of selenium combined with methimazole on thyroid function, exophthalmos, thyroid autoantibodies and cytokines in Graves disease with mild exophthalmos. Methods A number of 65 cases of Graves disease with mild exophthalmos were randomly divided into two groups： control group, observation group. The control group （n = 30） were received methimazole （15- 30 mg/d） and the observation group （n = 35） with methimazole （15- 30 mg/d） and selenium yeast （200 μg/d）. The levels of FT3, FT4, TSH, exophthalmos, TGAb, TRAb, TPOAb, IgG, IgA, IgM and cytokines IL-2 and IL-6 were tested before and 6 months after treatment. Results After 6 months of treatment, the levels of FT3, PT4, exophthalmos, TGAb, TRAb, IgG, IgA in two groups all decreased （P〈 0.05）, the difference between the two groups was statistically significant （P 〈 0.05）. The levels of TSH both increased （P 〈 0.05）, the difference between two groups were statistically significant （P〈 0.05）. The levels of TPOAb, IgM and IL-6 in two groups were lower than those before treatment （P〈 0.05）, but there was no significant difference between two groups （P〉0.05）. IL-2 were both increased （P〈 0.05）, but there was no significant difference between two groups （P〉 0.05）. Conclusions Selenium has anti-inflammatory effects in patients with Graves and Graves eye disease. Adjuvant therapy with selenium in Graves disease with mild exophthalmos has definite efficacy, which worths clinical application.

关 键 词：硒 GRAVES病 甲状腺功能 甲状腺自身抗体 细胞因子 

分 类 号：R581.4[医药卫生—内分泌]