摘要
目的探究硒酵母联合维生素D对青少年和成年桥本甲状腺炎(HT)患者的症状改善作用。方法选择2018年3月至2020年3月收治的HT患者201例,随机分为对照组(67例)和观察组(134例)。观察组又根据年龄分为青少年亚组(50例)和成年亚组(84例)。比较对照组和观察组的一般资料及治疗前后的实验室检查指标;比较青少年亚组和成年亚组治疗前、后的各项指标变化;通过Pearson检验分析血清硒、维生素D水平与各项指标的相关性;受试者工作特征(ROC)曲线分析血清硒、维生素D水平对HT患者症状改善的预测价值。结果观察组治疗后的血清硒、维生素D、游离三碘甲状腺原氨酸(FT_(3))、游离甲状腺素(FT_(4))和白介素-10(IL-10)水平明显高于对照组,促甲状腺素(TSH)、甲状腺过氧化物酶抗体(TPO-Ab)、甲状腺球蛋白抗体(TG-Ab)、促甲状腺激素受体抗体(TR-Ab)、干扰素γ(IFN-γ)和白介素-12(IL-12)水平明显低于对照组(P<0.05)。青少年亚组和成年亚组治疗后的FT_(3)、FT_(4)和IL-10水平均明显高于治疗前,TSH、TPO-Ab、TG-Ab、TR-Ab、IFN-γ和IL-12水平均明显低于治疗前,且成年亚组治疗后血清FT_(4)、TSH、TPO-Ab、TG-Ab、TR-Ab、IFN-γ、IL-12、IL-10水平的改善情况较青少年亚组显著(P<0.05)。血清硒、维生素D水平分别与FT_(3)、FT_(4)、IL-10呈明显正相关,与TSH、TPO-Ab、TG-Ab、TR-Ab、IFN-γ、IL-12呈明显负相关(P<0.05);血清硒、维生素D水平预测患者症状改善的ROC曲线下面积分别为0.815和0.795。结论硒酵母联合维生素D治疗HT能够明显改善青少年和成年患者的甲状腺功能、甲状腺自身抗体水平及炎性因子水平,且成年患者的改善效果更显著,血清硒、维生素D水平能够反映HT患者的症状改善情况。
AIM To explore the effect of selenium yeast combined with vitamin D on the improvement of symptoms of adolescent and adult patients with Hashimoto thyroiditis(HT).METHODS A total of 201 HT patients admitted to hospital from March 2018 to March 2020 were randomly divided into control group(67 patients)and observation group(134 patients),and the observation group was divided into adolescent subgroup(50 patients)and adult subgroup(84 patients)according to age.The general data and laboratory examination indexes before and after treatment were compared between control group and observation group.The indexes of adolescent subgroup and adult subgroup were compared before and after treatment.Pearson test was used to analyze the correlation between serum selenium and vitamin D levels and various indexes.The predictive value of serum selenium and vitamin D levels on symptom improvement of HT patients was analyzed by receiver operating characteristic(ROC)curve.RESULTS The serum levels of selenium,vitamin D,free triiodothyronine(FT_(3)),free thyroxine(FT_(4))and interleukin-10(IL-10)in observation group were significantly higher than those in control group after treatment,the levels of thyroid stimulating hormone(TSH),thyroid peroxidase antibody(TPO-Ab),thyroglobulin antibody(TG-Ab),thyroid stimulating hormone receptor antibody(TR-Ab),interferonγ(IFN-γ)and interleukin-12(IL-12)were significantly lower than those in control group(P<0.05).In the observation group,the levels of FT_(3),FT_(4)and IL-10 in the adolescent and adult subgroups after treatment were significantly higher than those before treatment,and the levels of TSH,TPO-Ab,TG-Ab,TR-Ab,IFN-γand IL-12 were significantly lower than those before treatment(P<0.05).After treatment,the levels of serum FT_(4),TSH,TPO-Ab,TG-Ab,TR-Ab,IFN-γ,IL-12 and IL-10 in adult subgroup were significantly imp roved compared with that in adolescent subgroup(P<0.05).Serum selenium and vitamin D levels were positively correlated with FT_(3),FT_(4)and IL-10,respectively,and negatively correlated with TSH,TPO-Ab,TG-Ab,TR-Ab,IFN-γand IL-12(P<0.05).The area under ROC curve for serum selenium and vitamin D levels to predict symptom improvement was 0.815 and 0.795,respectively.CONCLUSION Selenium yeast combined with vitamin D treatment of HT can significantly improve thyroid function,thyroid autoantibody levels and inflammatory factors in adolescent and adult patients,and the improvement effect is more significant in adult patients.Serum selenium and vitamin D levels can reflect the improvement of symptoms in HT patients.
作者
侯丽萍
谷巍
张雪坤
赵红玲
耿建林
HOU Liping;GU Wei;ZHANG Xuekun;ZHAO Hongling;GENG Jianlin(Department of Endocrinology,People's Hospital of Hengshui City,Hengshui 053000,China;Department of Geriatrics,People's Hospital of Hengshui City,Hengshui 053000,China)
出处
《中国临床药学杂志》
CAS
2022年第9期676-682,共7页
Chinese Journal of Clinical Pharmacy
基金
河北省卫生和计划生育委员会项目(编号20181595)
关键词
硒酵母
维生素D
桥本甲状腺炎
selenium yeast
vitamin D
Hashimoto thyroiditis
