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目的观察硒、碘对自身免疫性甲状腺炎(AIT)患者TPOAb及TGAb的影响。方法选取就诊于唐山市工人医院内分泌科2015年11月—2016年5月收治的196例AIT患者,符合本研究入选标准的有93例AIT(血清TPOAb≥200IU/ml,血清TGAb≥200IU/ml,TSH<10μIU/ml,尿碘≥200μg/L,无明显自身免疫性疾病、无明显肝肾疾病),在征得患者及家属同意情况下且根据病情,将其分为观察组和对照组,观察组包括补硒组(A组)32例,平均年龄(35.2±16.48)岁、补硒加适碘饮食组(B组)31例,平均年龄(39.4±14.27)岁,对照组30例,平均年龄(37.0±17.32)岁,给予常规治疗,比较三组患者分别于治疗前与治疗6个月后甲状腺功能及自身抗体变化等。结果三组患者分别于治疗前与治疗6个月后相比较,FT3、FT4、TSH水平未有明显改变,差异无统计学意义(P>0.05);A、B二组患者TPOAb水平下降,差异均有统计学意义(t_(A组)=7.67,t_(B组)=10.73,PA、B<0.05);TGAb水平虽有下降但差异无统计学意义(t_(A组)=1.18,t_(B组)=1.05,PA、B>0.05);对照组患者TPOAb升高显著有统计学意义(t=5.63,P<0.05),TGAb无明显改变,差异无统计学意义(P>0.05);对A、B二组患者进行组间比较TPOAb水平无明显改变,差异无统计学意义(t=1.82,P>0.05)。结论补硒可有效降低AIT患者TPOAb水平,缓解自身免疫状态。
Objective To observe the effects of selenium and iodine on TPOAb and TGAb in patients with autoimmune thyroiditis (AIT). Methods A total of 196 patients with AIT who were treated in Department of Endocrinology of Workers’ Hospital of Tangshan from November 2015 to May 2016 were enrolled in this study. 93 patients with AIT (serum TPOAb≥200IU / ml, serum TGAb≥200IU / ml , TSH <10μIU / ml, urinary iodine≥200μg / L, no obvious autoimmune disease, no obvious liver and kidney disease), with the consent of patients and their families, and according to the condition, it was divided into observation group and control group . The observation group included 32 cases in the selenium group (group A), with an average age of (35.2 ± 16.48) years and 31 cases of selenium plus iodine diet group (group B) with an average age of (39.4 ± 14.27) years and 30 cases in the control group , Mean age (37.0 ± 17.32) years old, given routine treatment, comparing the three groups of patients before and after treatment for 6 months, thyroid function and autoantibodies changes. Results There was no significant difference in FT3, FT4 and TSH levels between the three groups before treatment and 6 months after treatment (P> 0.05). The levels of TPOAb in group A and group B were significantly lower than those before treatment (T_ (group A) = 7.67, t_ (group B) = 10.73, PA, B <0.05). There was no significant difference in the level of TGAb (t_ (A group) = 1.18, t_ (Group B = 1.05, PA, B> 0.05). The TPOAb in control group was significantly increased (t = 5.63, P <0.05) There was no significant difference in TPOAb level between groups A and B (t = 1.82, P> 0.05). Conclusion Selenium supplementation can effectively reduce the level of TPOAb in AIT patients and relieve the autoimmune state.