局部注射曲安奈德联合左甲状腺素钠对桥本氏甲状腺炎的疗效  

Effect of local injection of triamcinolone acetonide combined with levothyroxine sodium on Hashimoto′s thyroiditis

作　　者：苏亚[1] 张哲[1] 梁园芳 余琴 SU Ya;ZHANG Zhe;LIANG Yuanfang;YU Qin(Department of Endocrinology,Shaanxi People′s Hospital,Xi′an 710068,China;Department of Endocrinology,the Second Affiliated Hospital of Xi′an Jiaotong University,Xi′an 710038,China)

机构地区：[1]陕西省人民医院内分泌科,西安710068 [2]西安交通大学第二附属医院内分泌科,西安710038

出　　处：《西北药学杂志》2020年第5期735-739,共5页Northwest Pharmaceutical Journal

基　　金：陕西省卫生厅科研基金项目(编号:2014JM30469)。

摘　　要：目的探讨局部注射曲安奈德联合左甲状腺素钠对桥本氏甲状腺炎患者的临床疗效及对血清内脂素和细胞因子的影响。方法选取桥本氏甲状腺炎患者85例,分为试验组43例和对照组42例,对照组给予左甲状腺素钠片常规治疗,试验组在对照组治疗的基础上给甲状腺部位局部注射曲安奈德。对比2组患者治疗后的有效率、甲状腺功能、不良反应、血清内脂素、细胞因子表达水平及甲状腺最大长径。结果试验组有效率明显高于对照组,差异具有统计学意义(χ^2=2.040,P=0.041);治疗后2组患者的血清游离三碘甲腺原氨酸(FT3)和游离四碘甲状腺原氨酸(FT4)水平均较治疗前明显上升,且试验组明显高于对照组,血清超敏促甲状腺激素(sTSH)、抗甲状腺球蛋白抗体(TGAb)和甲状腺过氧化物酶抗体(TPOAb)水平均较治疗前下降,且试验组均明显低于对照组(P<0.05),试验组不良反应总发生率明显低于对照组(χ^2=2.040,P=0.041);2组患者血清内脂素和细胞因子表达水平均较治疗前明显下降(P<0.05),且试验组明显低于对照组(P<0.05)。治疗前2组患者甲状腺最大长径比较差异无统计学意义(t=0.708,P=0.481),治疗后2组患者的甲状腺最大长径均较治疗前缩短(t=23.461,P=0.000;t=12.054,P=0.000),且试验组明显短于对照组(t=7.804,P=0.000)。结论局部注射曲安奈德联合左甲状腺素钠可改善桥本氏甲状腺炎患者的临床疗效,降低患者的血清内脂素和细胞因子表达水平。Objective To investigate the clinical effect of local injection of triamcinolone acetonide combined with levothyroxine sodium on hypothyroidism in Hashimoto′s thyroiditis and the effect on serum lipids and cytokines.Methods 85 patients with Hashimoto hypothyroidism were selected and divided into the experimental group(n=43)and the control group(n=42).The control group was given conventional treatment with Leothyroxine Sodium Tablets,and the experimental group was given local injection of Triamcinolone Acetonide Injections at the thyroid site on the basis of the control group.After treatment,the effective rate,thyroid function,adverse reactions,serum lipid,cytokine expression levels and thyroid maximum diameter were compared between the 2 groups.Results The effective rate of the experimental group was significantly higher than that of the control group,and the difference was statistically significant(χ^2=2.040,P=0.041).After treatment,the serum levels of free triiodothylamine(FT3)and free tetraiodothylamine(FT4)in both groups were increased significantly,and the experimental group is significantly higher than the control group.But the level of hypersensitive thyroid stimulating hormone(sTSH),anti-thyroglobulin antibody(TGAb)and thyroid peroxidase antibody(TPOAb)was decreased,the experimental group were significantly lower than the control group(P<0.05).The adverse reactions total rate in experimental group was significantly lower than in the control group(χ^2=2.040,P=0.041).After treatment,the expression levels of serum lipids and cytokines in both groups were significantly lower than those before treatment(P<0.05).And the experimental group was significantly lower than the control group(P<0.05).There was no significant difference in thyroid maximum diameter between the 2 groups before treatment(t=0.708,P=0.481),but after treatment,the thyroid maximum diameter of the 2 groups were smaller(t=23.461,P=0.000;t=12.054,P=0.000),and the experimental group was significantly smaller than the control group(t=7.804,P=0.

关 键 词：曲安奈德 左甲状腺素钠 血清内脂素 细胞因子 

分 类 号：R977[医药卫生—药品]