卡马西平联合左甲状腺素对甲状腺功能减退症患者血清IGFBP-3、25(OH)D3的影响  

Efficacy of Carbamazepine Plus Levothyroxine on Serum IGFBP-3 and 25(OH)D3 in Patients with Hypothyroidism

作　　者：孙琳琳 王凤梅 唐怡 赵雪莹 杨咏 SUN Lin-lin;WANG Feng-mei;TANG Yi;ZHAO Xue-ying;YANG Yong(Department of Endocrinology,Fushun Central Hospital,China Medical University,Fushun,Liaoning,113006,China)

机构地区：[1]中国医大附属一院集团抚顺市中心医院内分泌科,辽宁抚顺113006

出　　处：《现代生物医学进展》2020年第5期996-1000,共5页Progress in Modern Biomedicine

基　　金：辽宁省科学技术计划项目(2012225020)。

摘　　要：目的:探讨卡马西平联合左甲状腺素对甲状腺功能减退症患者血清胰岛素样生长因子结合蛋白-3(IGFBP-3)、25羟维生素D3(25(OH)D3)的影响。方法:选择2017年5月~2018年6月本院接诊的103例甲状腺功能减退症患者进行研究,通过随机数表法分为观察组52例和对照组51例,对照组给予左甲状腺素口服治疗,观察组在对照组基础上联合卡马西平口服治疗,两组患者均连续治疗8周。比较两组临床疗效、治疗前后甲状功能、血清IGFBP-3和25(OH)D3的变化情况及不良反应。结果:治疗后,观察组患者的临床疗效为94.23%,明显高于对照组患者的84.31%(P<0.05);观察组血清FT3、TSH均明显比对照组低,FT4明显高于对照组(P<0.05);两组患者治疗后IGFBP-3和25(OH)D3的指标水平均高于治疗前,且观察组结果高于对照组(P<0.05);观察组不良反应总发生率为5.76%,低于对照组的13.73%,两组不良反应总发生率差异无统计学意义(P>0.05)。结论:卡马西平联合左甲状腺素对甲状腺功能减退症患者临床效果显著,可有效改善患者甲状腺功能,调节患者血清IGFBP-3和25(OH)D3的表达水平,且不良反应少、安全性高,值得推广。Objective: To investigate clinical efficacy of carbamazepine plus levothyroxine on serum insulin-like growth factor binding protein-3(IGFBP-3) and 25-hydroxyvitamin D3(25(OH)D3) in patients with hypothyroidism. Methods: 103 patients with hypothyroidism admitted to our hospital from May 2017 to June 2018 were divided into the observation group(52 cases) and the control group(51 cases) by random number table method. The control group was given levothyroxine;and the observation group was combined with carbamazepine for oral treatment on the basis of the control group, and the patients in both groups were treated continuously for 8 weeks. Efficiency, thyroid function, serum IGFBP-3 and 25(OH)D3 levels and adverse reactions were compared between the two groups before and after treatment. Results: After treatment, the clinical efficacy in the observation group was 94.23%, which was significantly higher than 84.31% in the control group(P<0.05);the serum FT3 and TSH in the observation group were significantly lower than those in the control group, and FT4 was significantly higher than that in the control group(P<0.05);after treatment, the levels of IGFBP-3 and 25(OH)D3 in the two groups were higher than those before treatment, and the observation group were higher than the control group(P<0.05);the total incidence of adverse reactions in the observation group was 5.76%, which was lower than 13.73% in the control group,there was no significant difference between the two groups(P >0.05). Conclusion: The carbamazepine plus levothyroxine has a significant clinical efficiency on hypothyroidism. It can effectively improve the thyroid function of patients, regulate the expression level of IGFBP-3 and 25(OH)D3 in patients’ serum, with less adverse reactions and high safety. It is worthy of promotion.

关 键 词：甲状腺功能减退症 卡马西平 左甲状腺素 胰岛素样生长因子结合蛋白-3 25羟维生素D3 甲状腺素 

分 类 号：R581.2[医药卫生—内分泌]