硒补充治疗甲状腺功能减退症临床疗效的分析  

Analysis of clinical efficacy of selenium supplementation in the treatment of hyperthyroidism

作　　者：包丽颖 张宁[1] 刘海霞[2] 高荣 BAO Li-ying;ZHANG Ning;LIU Hai-xia;GAO Rong(Department of Pharmacy,The Second Hospital of Dalian Medical University,Dalian 116023,Liaoning Province,China;Department of Endocrinology,The Second Hospital of Dalian Medical University,Dalian 116023,Liaoning Province,China;Department of Pharmacy,Huludao Central Hospital,Huludao 125000,Liaoning Province,China)

机构地区：[1]大连医科大学附属第二医院,药学部,辽宁大连116023 [2]大连医科大学附属第二医院,内分泌科,辽宁大连116023 [3]葫芦岛市中心医院药剂科,辽宁葫芦岛125000

出　　处：《中国临床药理学杂志》2021年第15期2079-2081,共3页The Chinese Journal of Clinical Pharmacology

基　　金：中国药学会科技开发中心科普基金资助项目(CMEI2021KPYJ(JZX)00207)。

摘　　要：目的系统评价硒酵母对成人甲状腺功能减退症及甲状腺自身抗体的作用。方法计算机检索中国知网、万方数据库、维普数据库、PubMed、EmBase、Cochrane中英文生物医学数据库,收集硒酵母用于甲状腺功能减退症患者的随机对照试验(RCT)。对照组给予左甲状腺素治疗;试验组给予硒酵母联合左甲状腺素治疗。用RevMan 5.3软件对治疗有效率、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺激素(TSH)、甲状腺球蛋白抗体(TgAb)、甲状腺过氧化物酶抗体(TPOAb)、安全性水平进行Meta分析,并进行偏倚评估。结果共纳入11项研究,总计1007例患者,其中试验组507例,对照组500例。试验组在治疗有效率[相对危险比(RR)=1.21,95%Cl=1.151.28]、FT3[标准化差值(SMD)=1.10,95%Cl=0.921.27]、FT4(SMD=1.66,95%Cl=1.471.85)、TSH(SMD=-0.97,95%Cl=-1.14-0.80)、TPOAb(SMD=-0.80,95%Cl=-1.44-0.15)、TgAb(SMD=-1.04,95%Cl=-1.77-0.31)和安全性(RR=0.48,95%Cl=0.280.81)均明显优于对照组。结论硒酵母联合左甲状腺素治疗甲状腺功能减退症的效果优于左甲状腺素单一用药。Objective To systematically evaluate the effectiveness of selenium on hyperthyroidism and thyroid autoimmune antibodies.Methods CNKI,WanFang Data,VIP,PubMed,EmBase,Cochrane Chinese and English biomedical databases were searched,and randomized controlled trials(RCT)of selenium yeast for patients with hypothyroidism were collected.The control group was given levothyroxine treatment.The treatment group was given selenium yeast combined with levothyroxine treatment.Meta-analysis was performed with RevMan 5.3 software to evaluate the effective rate,free triiodothyronine(FT3),free thyroxine(FT4),thyroid-stimulating hormone(TSH),thyroglobulin antibody(TgAb),thyroid peroxidase antibody(TPOAb),and safety level,and bias assessment was conducted.Results A total of 11 studies were included,with a total of 1007 patients,including 507 in the treatment group and 500 in the control group.The effective rate of treatment in the treatment group[risk ratio(RR)=1.21,95%Cl=1.15-1.28],FT3[standardized mean difference(SMD)=1.10,95%Cl=0.92-1.27],FT4(SMD=1.66,95%Cl=1.47-1.85)TSH(SMD=-0.97,95%Cl=-1.14--0.80),TPOAb(SMD=-0.80,95%Cl=-1.44--0.15),Tg Ab(SMD=-1.04,95%Cl=-1.77--0.31)and safety(RR=0.48,95%Cl=0.28-0.81)were significantly better than those of control group.Conclusion The effect of selenium yeast combined with levothyroxine in the treatment of hypothyroidism was significantly better than that of levothyroxine single drug.

关 键 词：硒 甲状腺功能减退症 META分析 随机对照试验 

分 类 号：R97[医药卫生—药品]