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目的 探讨治疗成人亚临床甲状腺机能减退症 (SCH)的有效方法。方法 将 115例SCH分成两大组 ,随机分成四个亚组 ,进行替代和非替代治疗。分别观察其症状变化及血清总甲状腺素 (TT4) ,促甲状腺激素(TSH) ,血甘油三脂 (TG) ,胆固醇 (CH) ,高密度脂蛋白 (HDL -CH) ,低密度脂蛋白 (LDL -CH)的变化。结果 (1)SCH临床症状在采用替代治疗后明显改善 (P <0 0 5 ) ;而非替代治疗组则改善不明显 (P >0 0 5 )。 (2 )采用替代治疗后 ,从半年开始TSH下降 ,至两年后TSH平均水平趋于正常 ,非替代治疗组 ,则无明显变化。 (3)通过替代治疗两组血脂皆有明显下降 ,而非替代治疗组则无变化。 (4 )替代治疗两组 ,经过两年观察 ,SCH治愈明显增高 ,与非替代治疗组比较 ,差异显著 (P <0 0 5 )。结论 SCH早期给予替代治疗 ,可使症状缓解 ,血脂下降 ,SCH治愈率明显升高。
Objective To explore an effective method for treating subclinical hypothyroidism (SCH) in adults. Methods A total of 115 cases of SCH were divided into two groups and randomly divided into four subgroups for replacement and non-replacement therapy. The changes of symptoms and the changes of serum total thyroxine (TT4), thyrotropin (TSH), triglyceride (TG), cholesterol, high density lipoprotein (HDL-CH), low density lipoprotein -CH) changes. Results (1) The clinical symptoms of SCH were significantly improved after the replacement therapy (P <0.05), while those of the non-replacement therapy group were not significantly improved (P> 0.05). (2) After the replacement therapy, the TSH decreased from six months to two years later, the average level of TSH tended to be normal. There was no significant change in the non-replacement therapy group. (3) There was a significant decrease of blood lipids in both groups by alternative therapy, but no change in the non-treatment group. (4) After two years of treatment, SCH was significantly higher in the two alternative treatment groups, with significant difference (P <0 05) compared with the non-replacement treatment group. Conclusion SCH early replacement therapy, can relieve symptoms, decreased blood lipids, SCH cure rate was significantly higher.