亚硒酸钠治疗桥本甲状腺炎的临床观察

目的探讨硒对成人桥本甲状腺炎(HT)的干预效果。方法将176例HT患者中的甲状腺功能正常者121例和甲状腺功能减退(甲减)及亚临床甲减患者55例,分别分为对照组及治疗组,对照组根据甲状腺功能给予不用药或加用左旋甲状腺素片处置,治疗组在对照组治疗的基础上加用亚硒酸钠,观察亚硒酸钠对患者甲状腺过氧化物酶抗体(TPOAb)、甲状腺球蛋白抗体(TGAb)、甲状腺功能的影响。结果甲状腺功能正常组中硒治疗组患者的TPOAb、TGAb明显下降,与对照组比较差异有统计学(P<0.01,P<0.05﹚,而甲状腺功能方面,与对照组比较差异无统计学意义(P>0.05)。甲减及亚临床甲减组,随着TSH的下降,两组TPOAb、TGAb均有不同程度下降,但硒治疗组下降更明显,两组治疗前后比较差异有统计学意义(P<0.05﹚。硒治疗组无明显不良反应。结论补硒能降低HT患者甲状腺的自身抗体水平,可在一定程度上阻止甲状腺损害的发生和发展。

Clinical observation of treating autoimmune thyroiditis with Sodium selenite

Objective To observe the effect of selenium on adult autoimmune thyroiditis.Methods A total of 176 patients of autoimmune thyroiditis with normal thyroid-function(n=121) or hypothyroidism(n=55) were randomly divided into control group and trial group.The control group were given a standard treatment(without medication or with levothyroxine),and the trial group additionally given Sodium selenite.The changes in autoantibodies to thyroid peroxidase(TPOAb),thyroglobulin antibodies(TGAb) and thyroid-function were compared between the two groups after three months.Results The patients of normal thyroid-function: TPOAb and TGAb levels were more significantly decreased in the trial group than in the control group(P<0.01,P<0.05);thyroid-function were little changed without statistic difference between the two groups(P>0.05).The patients of hypothyroid and subclinical hypothyroid: although thyroid stimulating hormone(TSH),TPOAb and TGAb levels declined in both the two groups,the changes were more significant in the trial group(P<0.05).There was no evident side-effect in selenium-treated group.Conclusion Selenium helps to reduce thyroid autoantibody level in patients of autoimmune thyroiditis,and prevent occurrence and development of thyroid damage in a certain extent.