补硒治疗甲状腺功能正常的慢性淋巴细胞性甲状腺炎的疗效探究  

Study on the Effect of Selenium Supplementation on Hashimoto’s Thyroiditis with Normal Thyroid Function

作　　者：冼秋花 刘美志 孙杜桑 邱军辉 雷涛[1] Xian Qiuhua;Liu Meizhi;Sun Dusang(Putuo Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200062,China)

机构地区：[1]上海中医药大学附属普陀医院,200062 [2]上海中医药大学,201203

出　　处：《医学研究杂志》2019年第12期69-72,共4页Journal of Medical Research

基　　金：上海市医学重点专科科研项目(20174Y0181);上海市普陀区临床重点专科支撑项目(2016PTZK05)

摘　　要：目的观察补硒治疗甲状腺功能正常的慢性淋巴细胞性甲状腺炎(桥本甲状腺炎,HT)的临床疗效。方法选取上海中医药大学附属普陀医院内分泌科2016年10月~2018年10月收治的120例(其中TPOAb、TGAb未达到顶值者66例,TPOAb、TGAb达到顶值者54例)甲状腺功能正常的HT患者为研究对象。给予硒酵母胶囊(每次200μg,每日2次)治疗,比较患者治疗前后的游离三碘甲状腺原氨酸(FT 3)、游离甲状腺素(FT 4)、促甲状腺激素(TSH)、甲状腺过氧化物酶抗体(TPOAb)、甲状腺球蛋白抗体(TGAb)水平变化。结果当TPOAb、TGAb未达到顶值时(即TPOAb<1300U/ml,且TGAb<500U/ml),与治疗前比较,治疗3、6、12个月后患者血清TPOAb水平明显下降,差异有统计学意义(P<0.05)。补硒治疗3个月后,TGAb水平下降,但差异无统计学意义(P>0.05);治疗6、12个月后TGAb水平显著下降,差异有统计学意义(P<0.05)。当TPOAb、TGAb达到顶值时(即TPOAb>1300U/ml或TGAb>500U/ml),补硒治疗3、6个月后与治疗前血清TPOAb、TGAb水平比较,差异均有统计学意义(P<0.05);治疗12个月后,TPOAb、TGAb水平下降,但差异无统计学意义(P>0.05)。不管TPOAb、TGAb是否达到顶值,FT 3、FT 4、TSH水平与治疗前比较均无明显变化,差异无统计学意义(P均>0.05)。结论补硒治疗能够有效地降低慢性淋巴细胞性甲状腺炎患者体内TPOAb、TGAb水平,改善免疫反应,但对甲状腺功能无明显影响。Objective To observe the clinical efficacy of selenium supplementation in the treatment of Hashimoto′s thyroiditis with normal thyroid function.Methods A total of 120 HT patients(Among them,66 cases failed to reach the peak value of TPOAb and TGAb,and 54 cases reached the peak value of TPOAb and TGAb)with normal thyroid function treated in the Department of Endocrinology of Putuo Hospital Affiliated to Shanghai University of Traditional Chinese Medicine between October 2016 and 2018 October were selected as subjects.The patients were treated with selenious yeast capsules(200μg,2 times per day).Changes in FT 3,FT 4,TSH,TGAb and TPOAb levels were compared before and after treatment.Results When TPOAb and TGAb did not reach their peaks,compared with before treatment,serum TPOAb level reduced significantly 3,6 and 12 months after treatment,with statistically significant differences(P<0.05).TGAb level decreased 3 months after selenium supplementation,without statistically significant difference(P>0.05).And TGAb level reduced significantly 6 and 12 months after treatment,with statistically significant differences(P<0.05).When TPOAb and TGAb reached their peaks,serum TPOAb and TGAb levels of selenium supplementation 3 months and 6 months after treatment were significantly different from those before treatment(P<0.05).After 12 months of treatment,TPOAb and TGAb levels decreased,but there was no statistical significance(P>0.05).Whether the TPOAb and TGAb reach the peak value or not,FT 3,FT 4,TSH levels showed no obvious changes before and after treatment,without statistically significant differences(P>0.05).Conclusion Selenium supplementation can effectively reduce TPOAb and TGAb levels and improve immune response in patients with hashimoto′s thyroiditis,but has no significant effect on thyroid function.

关 键 词：慢性淋巴细胞性甲状腺炎 硒 甲状腺抗体 甲状腺功能 

分 类 号：R581[医药卫生—内分泌]