摘要
目的探讨硒联合甲巯咪唑对格雷夫斯病(Graves)病伴轻度突眼患者甲状腺功能、眼球突出度、甲状腺自身抗体及细胞因子的作用。方法选取Graves病伴轻度突眼患者共65例,随机分为对照组、观察组。对照组(30例)口服甲巯咪唑15~30 mg/d,观察组(35例)口服甲巯咪唑15~30 mg/d和硒酵母片100μg,2次/d。分别检测治疗前及治疗后6个月血清甲状腺激素(FT3、FT4)水平、促甲状腺激素(TSH)水平、眼球突出度变化、甲状腺自身抗体(TPOAb、TRAb、TGAb、IgG、IgA和IgM)及细胞因子(IL-2、IL-6)水平。结果治疗6个月后,两组患者FT_3、FT_4、眼球突出度水平、TGAb、TRAb、IgG及IgA水平均较治疗前降低,差异有统计学意义(P<0.05)。TSH水平升高,差异有统计学意义(P<0.05)。两组TPOAb、IgM、IL-6水平亦较治疗前降低(P<0.05),但治疗后两组比较差异无统计学意义(P>0.05)。IL-2水平升高(P<0.05),但治疗后两组比较差异无统计学意义(P>0.05)。结论硒在Graves病及Graves眼病患者中具有抗炎作用,硒辅助治疗Graves病伴轻度突眼具有一定的疗效,值得临床推广应用。
Objective To observe the effect of selenium combined with methimazole on thyroid function, exophthalmos, thyroid autoantibodies and cytokines in Graves disease with mild exophthalmos. Methods A number of 65 cases of Graves disease with mild exophthalmos were randomly divided into two groups： control group, observation group. The control group （n = 30） were received methimazole （15- 30 mg/d） and the observation group （n = 35） with methimazole （15- 30 mg/d） and selenium yeast （200 μg/d）. The levels of FT3, FT4, TSH, exophthalmos, TGAb, TRAb, TPOAb, IgG, IgA, IgM and cytokines IL-2 and IL-6 were tested before and 6 months after treatment. Results After 6 months of treatment, the levels of FT3, PT4, exophthalmos, TGAb, TRAb, IgG, IgA in two groups all decreased （P〈 0.05）, the difference between the two groups was statistically significant （P 〈 0.05）. The levels of TSH both increased （P 〈 0.05）, the difference between two groups were statistically significant （P〈 0.05）. The levels of TPOAb, IgM and IL-6 in two groups were lower than those before treatment （P〈 0.05）, but there was no significant difference between two groups （P〉0.05）. IL-2 were both increased （P〈 0.05）, but there was no significant difference between two groups （P〉 0.05）. Conclusions Selenium has anti-inflammatory effects in patients with Graves and Graves eye disease. Adjuvant therapy with selenium in Graves disease with mild exophthalmos has definite efficacy, which worths clinical application.
出处
《中国现代医学杂志》
CAS
北大核心
2017年第11期91-94,共4页
China Journal of Modern Medicine
