Department of Endocrinology, Wuwei People's Hospital, Wuwei, Gansu Province, China.
Endocr J. 2020 Jul 28;67(7):719-732. doi: 10.1507/endocrj.EJ19-0583. Epub 2020 Mar 31.
The goal of this study was to review relevant randomized controlled trials in order to determine the clinical efficacy of levothyroxine in the treatment of overt or subclinical hypothyroidism. Using appropriate keywords, we identified relevant studies using PubMed, the Cochrane library, and Embase. Key pertinent sources in the literature were also reviewed, and all articles published through December 2019 were considered for inclusion. For each study, we assessed odds ratios (ORs), mean difference (MD), and 95% confidence interval (95%CI) to assess and synthesize outcomes. We included 25 studies with totally 1,735 patients in the meta-analysis. In the patients with hypothyroidism, compared with L-T4, L-T4 plus L-T3 significantly decreased TSH levels and increased FT3 levels. Compared with placebo, L-T4 significantly increased FT4 levels and decreased TSH levels. In patients with subclinical hypothyroidism, compared with placebo, L-T4 significantly decreased SBP, TSH, T3 and TC and increased FT3 and FT4.
本研究旨在回顾相关的随机对照试验，以确定左甲状腺素治疗显性或亚临床甲状腺功能减退症的临床疗效。我们使用适当的关键词，通过 PubMed、Cochrane 图书馆和 Embase 检索到相关研究。还对文献中的关键来源进行了回顾，并考虑了截至 2019 年 12 月发表的所有文章。对于每项研究，我们评估了比值比（OR）、均数差（MD）和 95%置信区间（95%CI）来评估和综合结果。我们纳入了 25 项研究，共有 1735 名患者参与了荟萃分析。在甲状腺功能减退症患者中，与 L-T4 相比，L-T4 联合 L-T3 可显著降低 TSH 水平并升高 FT3 水平。与安慰剂相比，L-T4 可显著升高 FT4 水平并降低 TSH 水平。在亚临床甲状腺功能减退症患者中，与安慰剂相比，L-T4 可显著降低 SBP、TSH、T3 和 TC，升高 FT3 和 FT4。
