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硒蛋氨酸治疗自身免疫性甲状腺炎患者:一项前瞻性、准随机试验。

Selenomethionine treatment in patients with autoimmune thyroiditis: a prospective, quasi-randomised trial.

机构信息

Department of Endocrinology, 424 Military Hospital, Thessaloniki, Greece.

出版信息

Int J Clin Pract. 2012 Apr;66(4):378-83. doi: 10.1111/j.1742-1241.2011.02879.x. Epub 2012 Feb 22.

Abstract

AIMS

To test whether selenium administration affects autoantibodies to thyroid peroxidase (anti-TPO) and thyroglobulin (anti-TG) titres in chronic autoimmune (Hashimoto's - HT) thyroiditis.

METHODS

A prospective, open-label, quasi-randomised study in 86 HT patients (n = 86) assigned to either selenomethionine (Seme) 200μg daily for 3 months (Se3, n = 15) or 6 months (Se6, n = 46) or placebo (Control, n = 25). Serum Se, anti-TPO, anti-TG and thyroid hormones were measured in all patients at baseline, 3 and 6 months. A subgroup of 18 patients (twelve on Se6 and six controls) were subjected in thyroid fine-needle biopsy at baseline and 6 months to detect changes in lymphocyte infiltration.

RESULTS

No significant difference in anti-TPO levels was recorded after 3 (p = 0.88) or 6 months (p = 0.62) on Seme. Anti-TG levels decreased both at 3 months (p = 0.001) and 6 months (p = 0.001). No significant changes in thyroid stimulating hormone, free thyroxine and free triiodothyronine levels or in the lymphocytes' number in thyroid cytology specimens were detected. Age, gender, duration of disease, baseline anti-TPO levels and per cent change in Se levels could not predict the response of anti-TPO levels to Seme administration.

CONCLUSION

Our data suggest that Seme administration in pharmacological doses for a period of 6 months seems to have no significant effect on serum thyroid auto-antibodies' levels or lymphocyte infiltration of the thyroid gland.

摘要

目的

检测硒干预是否会影响慢性自身免疫性(桥本氏)甲状腺炎患者甲状腺过氧化物酶(抗 TPO)和甲状腺球蛋白(抗 TG)抗体滴度。

方法

86 例桥本氏甲状腺炎患者(n=86)进行前瞻性、开放标签、半随机研究,将患者分为三组,分别接受硒蛋氨酸(Seme)200μg/天(Se3,n=15)、Seme 6 个月(Se6,n=46)或安慰剂(对照组,n=25)治疗。所有患者于基线、3 个月和 6 个月时检测血清 Se、抗 TPO、抗 TG 和甲状腺激素。对其中 18 例患者(6 例 Se6 组和 6 例对照组)进行甲状腺细针穿刺活检,以检测淋巴细胞浸润的变化。

结果

Seme 治疗 3 个月(p=0.88)和 6 个月(p=0.62)后,抗 TPO 水平无显著差异。抗 TG 水平在 3 个月(p=0.001)和 6 个月(p=0.001)时均下降。甲状腺刺激激素、游离甲状腺素和游离三碘甲状腺原氨酸水平或甲状腺细胞学标本中淋巴细胞数量无显著变化。年龄、性别、疾病持续时间、基线抗 TPO 水平和 Se 水平变化百分比均不能预测抗 TPO 水平对 Seme 治疗的反应。

结论

我们的数据表明,在 6 个月的时间里,以药理剂量给予 Seme 治疗,似乎对血清甲状腺自身抗体水平或甲状腺淋巴细胞浸润无显著影响。

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