局部免疫调节对桥本甲状腺炎甲状腺功能减退的效果  

The efficacy of local immunomodulation in the treatment of hypothyroidism in Hashimoto's thyroiditis

作　　者：曾华蓉 柯志福 苏美梅 林琳[1] 胡天赤 ZENG Hua-Rong;KE Zhi-Fu;SU Mei-Mei(Xiamen Hospital,Beijing University of Traditional Chinese Medicine,Xiamen 361000,Fujian,China)

机构地区：[1]北京中医药大学厦门医院,福建厦门361000

出　　处：《吉林医学》2025年第2期276-280,共5页Jilin Medical Journal

基　　金：福建省科技厅引导性项目[项目编号:2020D018];福建省厦门市中医后备人才培养项目[项目编号:厦卫中医(2022)136号]。

摘　　要：目的:观察局部免疫调节治疗桥本甲状腺炎(HT)甲状腺功能减退的有效性及对生命质量的影响。方法:将88例新诊断亚临床甲状腺功能减退的HT患者随机分为观察组与对照组各44例,观察组予甲状腺局部注射地塞米松免疫调节治疗,对照组给予优甲乐治疗,连续治疗3个疗程,随访至1年,比较两组患者治疗前后甲状腺功能包括促甲状腺激素(TSH)、游离甲状腺素(FT4)、游离三碘甲状腺原氨酸(FT3)、抗甲状腺过氧化物酶抗体(TPOAb)、抗甲状腺球蛋白抗体(TgAb)、甲状腺体积,停止治疗后复发率及甲状腺相关疾病生存质量评分。结果:最终有73例患者完成研究,观察组37例,对照组36例。3个疗程结束后,与对照组比较,观察组改善TPOAb、TgAb优于对照组,差异有统计学意义(P<0.05),对于甲状腺功能(TSH、FT3、FT4)改善两组差异无统计学意义(P>0.05);观察组在缩小甲状腺体积及改善甲状腺相关疾病生存质量评分方面优于对照组,差异有统计学意义(P<0.05),且停止治疗后观察组甲减复发率少于对照组,差异有统计学意义(P<0.05)。结论:局部免疫调节治疗桥本甲状腺炎甲减有效,且能减少停止治疗后甲减复发,提高患者生命质量。Objective To observe the effectiveness of local immunomodulatory treatment of Hashimoto's thyroiditis hypothyroidism and its influence on quality of life.Method A total of 88 newly diagnosed subclinical hypothyroidism HT patients were randomly divided into observation group and control group,44 cases in each group.The observation group was given local injection of dexamethasone immunoregulatory therapy for thyroid,and the control group was given unimethylate therapy for 3 consecutive courses of treatment.Follow-up was up to 1 year.Thyroid function,including thyroid stimulating hormone(TSH),free thyroxine(FT4),free triiodothyronine(FT3),anti-thyroid peroxidase antibody(TPOAb),anti-thyroglobulin antibody(TgAb),thyroid volume,recurrence rate after stopping treatment and quality of life score of thyroid related diseases were compared between the two groups before and after treatment.Results 73 patients completed the study,37 in the observation group and 36 in the control group.After 3 treatment courses,compared with the control group,the improvement of TPOAb and TgAb in the observation group was better than that in the control group,with statistical difference(P<0.05),while there was no statistical difference in the improvement of thyroid function(TSH,FT3,FT4)between the two groups(P>0.05).The observation group was superior to the control group in reducing thyroid volume and improving quality of life score of thyroid related diseases(P<0.05),and the recurrence rate of hypothyroidism in the observation group was lower than that in the control group after stopping treatment(P<0.05).Conclusion Local immune modulation therapy for Hashimoto's thyroiditis hypothyroidism is effective,and can reduce the recurrence of hypothyroidism after stopping treatment and improve the quality of life of patients.

关 键 词：桥本甲状腺炎 甲状腺功能减退 局部免疫调节治疗 地塞米松 生命质量 

分 类 号：R581[医药卫生—内分泌]