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目的 探讨甲状腺激素替代治疗轻微甲状腺功能减退 (甲减 )的临床疗效。方法 将门诊或住院并确诊为轻微甲减的 6 5例患者均采用甲状腺激素替代治疗 ,观察治疗 1、6个月后临床症状、体征的变化 ,以及血清总甲状腺素 (TT4)、游离甲状腺素 (FT4)、促甲状腺素 (TSH)、甲状腺球蛋白抗体 (TGA)、甲状腺微粒体抗体 (MCA)、总胆固醇 (TCH)、低密度脂蛋白 (LDL C)、高密度脂蛋白 (HDL C)与脂蛋白 (a) [Lp(a) ]的变化。结果 替代治疗 1个月后 ,临床症状及TSH开始改善 ,6个月后效果更为显著 (P <0 .0 1 )。治疗 6个月后TCH、LDL C平均下降 0 .3mmol/L ,但前后比较无显著性差异。TT4、FT4、TGA、MCA、HDL C、Lp(a)治疗前后均无明显变化 (P >0 .0 5 )。结论 轻微甲减早期行替代治疗可使症状、体征改善 ,胆固醇水平下降 ,可防止发展为典型甲减而造成对健康的不利影响
Objective To investigate the clinical efficacy of thyroid hormone replacement therapy for mild hypothyroidism (hypothyroidism). Methods Thyroid hormone replacement therapy was used in outpatients or inpatients who were diagnosed with mild hypothyroidism. The clinical signs and symptoms were observed after 1 and 6 months of treatment. The levels of total thyroxine (TT4), free thyroxine (FT4, TSH, TGA, MCA, TCH, HDL C, HDL C) And lipoprotein (a) [Lp (a)] changes. Results After 1 month of replacement therapy, clinical symptoms and TSH started to improve, and the effect was more obvious after 6 months (P <0.01). After 6 months of treatment, TCH and LDL C decreased by an average of 0.3 mmol / L, but there was no significant difference between before and after treatment. TT4, FT4, TGA, MCA, HDL C, Lp (a) had no significant changes before and after treatment (P> 0.05). Conclusions Slight hypothyroidism early replacement therapy can improve the symptoms, signs, cholesterol levels, can prevent the development of a typical hypothyroidism caused by adverse health effects