硒酵母联合甲状腺素类药物对桥本甲状腺炎患者甲状腺功能、炎症因子的影响  

Effects of Selenium Yeast Combined with Thyroid Drug on Thyroid Function and Inflammatory Factors in Patients with Hashimoto's Thyroiditis

作　　者：赵芳芳 余蓬燕 冀肖燕 戴慧慧 Zhao Fangfang;Yu Pengyan;Ji Xiaoyan;Dai Huihui(Boai County People's Hospital Jiaozuo,Henan 454450;The 988th Hospital of the PLA Joint Logistics Support Force Jiaozuo,Henan 454003)

机构地区：[1]博爱县人民医院,河南焦作454450 [2]解放军联勤保障部队第九八八医院,河南焦作454003

出　　处：《辽宁医学杂志》2024年第6期49-52,共4页Medical Journal of Liaoning

摘　　要：目的 分析桥本甲状腺炎甲状腺功能减退患者使用硒酵母联合甲状腺素类药物(左甲状腺素钠片)后甲状腺功能、炎症因子的变化情况。方法 选择医院2020年6月至2023年12月诊治的桥本甲状腺炎甲状腺功能减退患者188例,使用随机数字法平均分为常规组、研究组,94例/组。常规组口服左甲状腺素钠片治疗,研究组使用硒酵母联合左甲状腺素钠片治疗。比较2组患者甲状腺功能[游离甲状腺素(FT4)、游离三碘甲状腺原氨酸(FT3)、促甲状腺激素(TSH)]、甲状腺自身抗体水平[甲状腺球蛋白抗体(TGAb)和甲状腺过氧化物酶抗体(TPOAb)]、炎性因子水平[干扰素-y(IFN-y)、白介素-12(IL-12)及白介素-10(IL-10)]及不良反应。结果 治疗结束1d, 2组患者FT3、FT4水平均高于治疗前(均P<0.05),TSH水平低于治疗前(均P<0.05)。治疗结束1d,研究组患者FT3(5.69±1.89)pmol/L、FT4(18.36±4.74)pmol/L均高于常规组(均P<0.05),TSH(6.39±1.71)mIU/L低于常规组(均P<0.05)。治疗结束1d, 2组患者TGAb、TPOAb水平均低于治疗前(均P<0.05)。治疗结束1d,研究组患者TGAb、TPOAb水平低于常规组(均P<0.05)。治疗结束1d,研究组患者TGAb(211.51±13.06)IU/ml、TPOAb(302.87±52.69)IU/ml低于常规组(均P<0.05)。治疗结束1d,治疗结束1d,研究组患者IFN-y(1.12±0.11)μg/L、IL-12(0.81±0.12)μg/L均低于常规组(均P<0.05),TL-10(17.69±5.97)μg/L水平高于常规组(均P<0.05)。研究组(12.77%)与对照组不良反应总率(11.70%)无统计学差异(P>0.05)。结论 左甲状腺素钠片基础上使用硒酵母治疗HT甲状腺功能减退,降低疾病活动度,减轻炎症反应,改善患者甲状腺功能,建议使用。Objective To investigate the effects of selenium yeast combined with thyroid drug(levothyroxine sodium)on thyroid function and inflammatory factors in patients with Hashimoto's thyroiditis.Methods 188 patients with hypothyroid-ism due to Hashimoto's thyroiditis in our hospital from June 2020 to December 2023.were selected,and divided equally into two groups using random number method,each with 94cases.Routine group received levothyroxine sodium tablets orally,while study group received selenium yeast combined with levothyroxine sodium tablets.Then comparison was conducted on thyroid function parameters[free triodothyronine(FT3),free thyroxine(FT4),thyroid stimulating hormone(TSH)],thyroid autoantibody[thyroglobulin antibody(TGAb)and thyroid peroxidase antibody(TPOAb)],inflammatory factors[interferon-(IFN-),interleukin-12(IL-12)and interleukin-10(IL-10)] and the adverse reactions.Results Compared with baseline data,an increase in FT3 and FT4 along with a decrease in TSH were observed in two groups at post-treatment 1d(all P<0.05),and both changes were more remarkable in study group than in routine group(all P<0.05).At post-treatment 1d,levels of two thyroid autoantibody indicators were decreased in both groups(all P<0.05),and the decrease was more nota-ble in study group compared with routine group(all P<0.05).At post-treatment 1d,levels of IFN-and IL-12 were de-creased(all P<0.05),and IL-10 level was increased in both groups(all P<0.05).Study group had lower IFN-and IL-12 levels as well as higher IL-10 levels compared with routine group(all P<0.05).The total adverse reaction rates of the study group and the control group were 12.77%and 11.70%respectively,with no significant difference(P>0.05).Con-clusion On the basis of levothyroxine sodium tablets,selenium yeast is used to treat HT hypothyroidism,reduce disease ac-tivity,reduce inflammatory reaction and improve thyroid function.It is recommended to use selenium yeast.

关 键 词：硒酵母 左甲状腺素钠片 桥本甲状腺炎 甲状腺功能减退 甲状腺自身抗体 炎性因子 

分 类 号：R581.4[医药卫生—内分泌]