口服亚硒酸钠和维生素E对高海拔地区心血管病患者甲状腺激素的影响

目的探讨使用亚硒酸钠和维生素E对高海拔地区心血管病患者甲状腺激素的影响.方法将心血管病患者随机分为3组A组42例患者口服亚硒酸钠,同时加服维生素E;B组28例患者口服亚硒酸钠;对照组20例,未服用亚硒酸钠及维生素E.观察对象分别于治疗前和治疗6个月后抽血检测血清硒(Se)、血浆谷胱甘肽过氧化物酶(GSH-Px)活力、丙二醛(MDA)含量及甲状腺激素(T3、T4)等指标,以观察远期疗效.结果治疗后A组和B组血清Se含量(0.71±0.22)、(0.68±0.18)μmol/L]明显高于治疗前(0.31±0.17)、(0.33±0.14)μmol/L],差异有显著性(P＜0.01);A组和B组血浆GSH-Px活力分别为(87.12±13.61)、(84.79±12.13)U/L,较治疗前分别为(58.43±18.93)、(57.12±17.36)U/L]明显增加.A组和B组MDA含量(4.86±1.18)、(4.18±1.23)nmol/ml]较治疗前(8.66±0.96)、(8.71±0.87)nmol/ml]明显降低,差异均有显著性(P＜0.01);A组和B组患者T3和T4较对照组明显降低,趋于正常.血清Se与血浆GSH-Px呈正相关(r=0.781,P＜0.01),与MDA、T3、T4浓度呈负相关(r=-0.385;r=-0.687;r=-0.412,均P＜0.05).甲状腺激素恢复正常者A组31例(73.81%)、B组20例(71.42%);部分恢复者A组4例(9.52%)、B组2例(7.43%),其恢复率明显高于对照组,差异有显著性(P＜0.05),远期疗效较好.结论补充适量硒和维生素E可纠正高原环境下因低Se而引起的甲状腺激素代谢异常.

Influence of oral sodium selenite and vitamin E on thyroid hormones in patients with cardiovascular disease at altitude

OBJECTIVE: To investigate the effect of oral sodium selenite and vitamin E on thyroid hormones in patients with cardiovascular disease at altitude. METHODS: Ninety patients with cardiovascular disease were divided into A group (n = 42, sodium selenite + VE), B group (n = 28, sodium selenite only) and control group (n = 20). Serum selenium (Se), plasma glutathione peroxidase (GSH-Px), plasma malondialdehyde (MDA) and serum T(3) and T(4) were determined before and after 6 month treatment. RESULTS: Serum Se in A and B group after 6 month treatment were higher than before (0.71 +/- 0.22) micromol/L vs (0.31 +/- 0.17) micromol/L, (0.68 +/- 0.18) micromol/L vs (0.33 +/- 0.14) micromol/L respectively, P < 0.01], and so were plasma GSH-Px levels (87.12 +/- 13.61) U/L vs (58.43 +/- 18.93) U/L, (84.79 +/- 12.13) U/L vs (57.12 +/- 17.36) U/L respectively] while plasma MDA were lower than before (4.86 +/- 1.18) nmol/ml vs (8.66 +/- 0.96) nmol/ml, (4.18 +/- 1.23) nmol/ml vs (8.71 +/- 0.87) nmol/ml respectively, P < 0.01]. Serum T(3) and T(4) levels in A and B group were also obviously decreased (P < 0.01). The levels of plasma GSH-Px were positively correlated with those of serum Se (r = 0.781, P < 0.01). The levels of plasma MDA and serum T(3) and T(4) were negatively correlated with those of serum Se (r = -0.385, -0.687, -0.412 respectively, P < 0.05). 31 cases (73.81%) in A group and 20 cases (71.42%) in B group completely recovered to normal; 4 cases (9.52%) in A group and 2 cases (7.43%) in B group partly recovered. The recovered rates were significantly different from that of control (P < 0.05). CONCLUSION: Supplementation of adequate selenium may correct the abnormal function of secretion in thyroid hormones of patients because of lack of selenium at altitude areas.