左旋甲状腺素、硒酵母联合治疗淋巴细胞性甲状腺炎的临床价值观察

目的观察左旋甲状腺素、硒酵母联合治疗淋巴细胞性甲状腺炎的临床价值。方法120例淋巴细胞性甲状腺炎患者,根据治疗方法不同分为对照组和研究组,每组60例。对照组患者口服左旋甲状腺素钠片治疗,研究组患者在对照组基础上联合硒酵母片口服治疗。比较两组临床疗效,治疗前后甲状腺功能指标游离甲状腺素(FT4)、游离三碘甲状腺原氨酸(FT3)、促甲状腺激素(TSH)、甲状腺过氧化物酶抗体(TPOAb)、甲状腺球蛋白抗体(TGAb)]水平及T淋巴细胞指标(CD8^+、CD4^+、CD3^+、CD4^+/CD8^+)水平,不良反应发生情况、复发情况。结果研究组治疗总有效率95.00%高于对照组的81.67%,差异具有统计学意义(P<0.05)。治疗后,两组FT4、FT3、TSH、TPOAb、TGAb水平均优于治疗前,差异均具有统计学意义(P<0.05);且研究组FT4(18.2±1.8)pmol/L、FT3(5.4±1.1)pmol/L均高于对照组的(12.1±1.7)、(3.4±0.8)pmol/L,TSH(4.9±0.7)mU/L、TPOAb(125.3±13.2)U/L、TGAb(65.27±8.4)U/L均低于对照组的(7.8±1.1)mU/L、(206.2±17.8)U/L、(88.5±10.5)U/L,差异均具有统计学意义(P<0.05)。研究组CD8^+水平(23.2±3.8)%低于对照组的(25.2±4.0)%,CD4^+(28.2±3.8)%、CD3^+(40.4±5.5)%、CD4^+/CD8^+(1.2±0.2)均高于对照组的(26.8±3.6)%、(37.4±4.7)%、(1.1±0.1),差异均具有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05);研究组57例经治疗有效的患者均未出现复发,对照组49例治疗有效患者出现4例(8.16%)复发,研究组复发率低于对照组,差异具有统计学意义(P<0.05)。结论给予淋巴细胞性甲状腺炎患者左旋甲状腺素联合硒酵母治疗能够有效提高治疗效果,促进恢复甲状腺内分泌功能,具有临床推广价值。

Observation on clinical value of levothyroxine and selenium yeast in the treatment of lymphocytic thyroiditis

Objective To observe the clinical value of levothyroxine and selenium yeast in the treatment of lymphocytic thyroiditis.Methods A total of 120 patients with chronic lymphocytic thyroiditis were divided into control group and research group by different treatment methods,with 60 cases in each group.The control group was treated by oral administration of levothyroxine sodium tablets,and the research group was treated by oral administration of selenium yeast on the basis of the control group.The clinical efficacy,thyroid function index levelfree thyroxine(FT4),free triiodothyronine(FT3),thyroid stimulating hormone(TSH),thyroid peroxidase antibody(TPOAb),thyroglobulin antibody(TGAb)]before and after treatment,T lymphocyte indexes(CD8^+,CD4^+,CD3^+,CD4^+/CD8^+)levels,occurrence of adverse reactions and recurrence situation were compared between the two groups.Results The total effective rate of treatment 95.00%in the research group was higher than 81.67%in the control group,and the difference was statistically significant(P<0.05).After treatment,the levels of FT4,FT3,TSH,TPOAb and TGAb in the two groups was better than those before treatment.The levels of FT4(18.2±1.8)pmol/L and FT3(5.4±1.1)pmol/L in the research group were higher than(12.1±1.7)and(3.4±0.8)pmol/L in the control group,and levels of TSH(4.9±0.7)mU/L,TPOAb(125.3±13.2)U/L and TGAb(65.27±8.4)U/L in the research group were lower than(7.8±1.1)mU/L,(206.2±17.8)U/L and(88.5±10.5)U/L in the control group.Their difference was statistically significant(P<0.05).The CD8+level(23.2±3.8)%in the research group was lower than(25.2±4.0)%in the control group,and levels of CD4^+(28.2±3.8)%,CD3^+(40.4±5.5)%and CD4^+/CD8^+(1.2±0.2)in the research group were higher than(26.8±3.6)%,(37.4±4.7)%and(1.1±0.1)in the control group.Their difference was statistically significant(P<0.05).There was no statistically significant difference in incidence of adverse reactions between the two groups(P>0.05).57 patients in the research group did not recur after treatment,and 4 patients(8.16%)in the control group recurred after treatment.The recurrence rate in the research group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion Levothyroxine combined with selenium yeast treatment in patients with chronic lymphocytic thyroiditis can effectively improve the treatment effect and promote the restoration of thyroid endocrine function,which contains clinical promotion value.