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甲状腺功能减退症年轻女性接受左甲状腺素/三碘甲状腺原氨酸联合治疗后的性功能和抑郁症状:一项初步研究。

Sexual function and depressive symptoms in young women with hypothyroidism receiving levothyroxine/liothyronine combination therapy: a pilot study.

机构信息

a Department of Internal Medicine and Clinical Pharmacology , Medical University of Silesia , Katowice , Poland.

出版信息

Curr Med Res Opin. 2018 Sep;34(9):1579-1586. doi: 10.1080/03007995.2018.1448771. Epub 2018 Mar 29.

DOI:10.1080/03007995.2018.1448771
PMID:29508635
Abstract

Objective Even mild hypothyroidism in pre-menopausal women is accompanied by impaired sexual functioning. The study was aimed at comparing the effect of levothyroxine, administered alone or in combination with liothyronine, on sexual function and depressive symptoms in pre-menopausal women treated because of hypothyroidism. Methods This quasi-randomized, single-blind study included 39 young women receiving levothyroxine treatment who, despite thyrotropin and thyroid hormone levels within normal limits, still experienced clinical symptoms of hypothyroidism. These patients were divided into two groups: group A (n = 20) continued levothyroxine treatment, while group B (n = 19) received levothyroxine/liothyronine combination therapy. At the beginning of the study, and 6 months later, all participants of the study filled in questionnaires evaluating female sexual functioning (Female Sexual Function Index; FSFI) and the presence and severity of depressive symptoms (Beck Depression Inventory-Second Edition; BDI-II). Results The study was completed by 37 women. Baseline sexual functioning and depressive symptoms did not differ between the study groups. Neither the total FSFI score nor the domain scores changed throughout the study in women who continued levothyroxine treatment. Compared to levothyroxine administered alone, levothyroxine/liothyronine combination therapy increased scores for two domains: sexual desire and arousal, tended to increase the total FSFI score, as well as tended to decrease the overall BDI-II score. The effect of the combination therapy on sexual function correlated with a treatment-induced increase in serum levels of free triiodothyronine and testosterone. Conclusions The obtained results suggest that levothyroxine administered together with liothyronine is superior to levothyroxine administered alone in affecting female sexual functioning.

摘要

目的 即使是绝经前妇女的轻度甲状腺功能减退症也伴有性功能障碍。本研究旨在比较左甲状腺素单药治疗与左甲状腺素联合三碘甲状腺原氨酸治疗对甲状腺功能减退症女性患者性功能和抑郁症状的影响。

方法 这是一项准随机、单盲研究,纳入了 39 名正在接受左甲状腺素治疗的年轻女性,尽管促甲状腺激素和甲状腺激素水平正常,但仍有甲状腺功能减退的临床症状。这些患者被分为两组:A 组(n=20)继续左甲状腺素治疗,B 组(n=19)接受左甲状腺素/三碘甲状腺原氨酸联合治疗。在研究开始时和 6 个月后,所有研究参与者都填写了评估女性性功能的问卷(女性性功能指数;FSFI)和抑郁症状的存在和严重程度(贝克抑郁量表第二版;BDI-II)。

结果 37 名女性完成了研究。研究组之间的基线性功能和抑郁症状无差异。继续左甲状腺素治疗的女性,FSFI 总分和各领域评分在整个研究过程中均无变化。与单独使用左甲状腺素相比,左甲状腺素/三碘甲状腺原氨酸联合治疗可提高性欲和唤起两个领域的评分,FSFI 总分也有升高趋势,BDI-II 总分也有下降趋势。联合治疗对性功能的影响与治疗诱导的血清游离三碘甲状腺原氨酸和睾酮水平升高相关。

结论 这些结果表明,左甲状腺素联合三碘甲状腺原氨酸治疗优于左甲状腺素单药治疗,对女性性功能有影响。

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