Sun Chunping, Zhu Min, Li Li, Fan Hua, Lv Fang, Zhu Defa
Department of Endocrinology, The First Affiliated Hospital of Anhui Medical University, Anhui Gerietric Institute, Hefei, Anhui 230022, China.
Department of Endocrinology, The Third Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230022, China.
Evid Based Complement Alternat Med. 2021 Oct 27;2021:5471281. doi: 10.1155/2021/5471281. eCollection 2021.
The purpose of this study was to investigate the therapeutic effects of levothyroxine sodium combined with selenium treatment and single levothyroxine sodium treatment on patients with chronic lymphocytic thyroiditis and hypothyroidism and to analyze the effects of different treatment regimens on patients' thyroid function, mood, and inflammatory factors, with the aim of providing a reference for clinical treatment. The subjects of the current study were 138 chronic lymphocytic thyroiditis (CLT) patients with hypothyroidism admitted to our hospital from May 2016 to September 2019 and were randomly divided into a control group taking levothyroxine sodium (LT4) treatment and a combined group of LT4 combined with selenium treatment, with 69 cases each. Patients in both groups were evaluated for efficacy after 3 months of treatment, and their thyroid function was observed by total triiodothyronine (TT3), total thyroxine (TT4), thyroid stimulating hormone (TSH), thyroid peroxidase antibody (TPOAb), and thyroid globulin antibody (TGAb), and their mood changes were observed by Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) scores. The levels of inflammatory factors such as interleukin-2 (IL-2), interleukin-10 (IL-10), and tumor necrosis factor- (TNF-) were measured, and the occurrence of adverse drug reactions during the treatment period was observed and recorded in all patients. The results showed that the total effective rate of the combined group was significantly higher than that of the control group. The levels of TT3, TT4, TSH, TgAb, and TPOAb, SAS and SDS scores, and levels of inflammatory factors such as IL-2, IL-10, and TNF- were significantly improved in both groups after treatment. Compared with the control group, TGAb, TPOAb, IL-2, TNF- levels, and SAS and SDS scores decreased more and IL-10 levels increased more in the combined group, while the differences of other indexes were not statistically significant. This suggests that LT4 has certain efficacy in treating CLT with hypothyroidism, and the combined selenium treatment can improve the therapeutic effect of LT4 and can play a greater role in improving patients' mood and immune and inflammatory responses.
本研究旨在探讨左甲状腺素钠联合硒治疗与单纯左甲状腺素钠治疗对慢性淋巴细胞性甲状腺炎合并甲状腺功能减退患者的治疗效果，并分析不同治疗方案对患者甲状腺功能、情绪及炎症因子的影响，为临床治疗提供参考。本研究的对象为2016年5月至2019年9月我院收治的138例慢性淋巴细胞性甲状腺炎（CLT）合并甲状腺功能减退患者，随机分为服用左甲状腺素钠（LT4）治疗的对照组和LT4联合硒治疗的联合组，每组69例。两组患者治疗3个月后评估疗效，通过总三碘甲状腺原氨酸（TT3）、总甲状腺素（TT4）、促甲状腺激素（TSH）、甲状腺过氧化物酶抗体（TPOAb）和甲状腺球蛋白抗体（TGAb）观察甲状腺功能，通过自评焦虑量表（SAS）和自评抑郁量表（SDS）评分观察情绪变化。检测白细胞介素-2（IL-2）、白细胞介素-10（IL-10）和肿瘤坏死因子-（TNF-）等炎症因子水平，并观察记录所有患者治疗期间药物不良反应的发生情况。结果显示，联合组总有效率显著高于对照组。治疗后两组TT3、TT4、TSH、TgAb和TPOAb水平、SAS和SDS评分以及IL-2、IL-10和TNF-等炎症因子水平均显著改善。与对照组相比，联合组TGAb、TPOAb、IL-2、TNF-水平及SAS和SDS评分下降更多，IL-10水平升高更多，而其他指标差异无统计学意义。这表明LT4治疗CLT合并甲状腺功能减退有一定疗效，联合硒治疗可提高LT4的治疗效果，在改善患者情绪及免疫和炎症反应方面能发挥更大作用。
