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《Chinese Journal of Difficult and Complicated Cases》 2017-01
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Changes of TSH,FT_3,FT_4,TPOAb and TGAb in patients with hypothyroidism treatment with levothyroxine and selenium supplement

SUN Jingru;HAN Mei;WANG Lu;SUN Wenwen;Department of Thoracic Surgery,Hebei Chest Hospital;Department of Endocrinology,Laoning Jinqiu Hospital;  
Objective To observe the clinical results and changes in TSH,FT_3,FT_4,TPOAb and TGAb of patients with hypothyroidism in treatment with levothyroxine and selenium supplement.Methods Ninety-two cases of patients with hypothyroidism were selected,which were treated in hospital from March 2015 to March 2016,and they were divided into the observation group(46 cases) and control group(46 cases).The patients of control group were treated with levothyroxine tablets(an initial dose of 25 μg,1 time / d,dose adjustment after two weeks of continuous treatment,increasing 25μg each time,until the optimum effect).On the basis of control group,the patients of observation group were treated with selenium yeast tablets(50 μg,orally,2 times / d).The patients of two groups were all treated for 6months.Compare the clinical efficacy and changes of the levels of free three triiodothyronine(FT_3),free four triiodothyronine(FT_4),thyroid stimulating hormone(TSH),thyroid peroxidase antibody(TPOAb),thyroglobulin antibody(TGAb),high density lipoprotein protein(HDL-C),low density lipoprotein(LDL-C),total cholesterol(TC),triglyceride(TG) of two groups.Results After the appropriate treatment,the patients of the observation group got a total effective rate of 95.7%,which was significantly better than the 82.6%of the control group(x~2 =4.039,P =0.044);In the terms of TSH,TPOAb,TGAb,LDL-C,TC and TG,the patients of two groups were all significantly decreased than before(observation group:t =45.159,t =6.243,t =9.266,t =17.969,t =17.146,t =17.669,control group;t =44.144,t =3.971,t =7.168,t =12.415,t =9.402,t =10.621.P 0.05),and the patients of the observation group got more significant decline(t = 1.896,t =2.685,t =2.061,t =7.058,t=10.636,t=8.724,P0.05);In the terms of FT_3,the patients of two groups were all significantly increased than before(observation group:t=14.524,t=7.673,control group:t=12.723,t=5.903,P0.05),and in the terms of FT_3,the patients of the observation group got more significant increase(t=2.151,P0.05);there were headache,gastrointestinal discomfort,chest tightness,tachycardia,allergic reactions and other adverse reactions occurred in both two groups,but there were no statistically significant between the two groups(X~2=1.170,X~2=0.474,X~2=0.000,X~2=1.593,X~2=2.224,P 0.05).Conclusion With treating patients with hypothyroidism,levothyroxine and selenium supplement can significantly improve the clinical efficacy,effectively improve the levels of thyroid and autoantibodies,and it is also safe and reliable,which makes it worthy of promotion.
【CateGory Index】: R581.2
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