硒酵母联合维生素D对不同年龄分层的桥本甲状腺炎患者甲状腺相关抗体水平的影响
收稿日期: 2020-11-24
网络出版日期: 2022-07-25
基金资助
2018年度河北省医学科学研究重点课题计划项目(20181595)
Effect of selenium yeast combined with vitamin D on thyroid-associated antibody levels in patients with Hashimoto thyroiditis at different ages
Received date: 2020-11-24
Online published: 2022-07-25
目的：探讨硒酵母联合维生素D在不同年龄分层的桥本甲状腺炎（Hashimoto thyroiditis,HT）患者甲状腺相关抗体水平的影响。方法：选择2017年12月—2019年12月于我院内分泌科就诊的HT患者148例（成年患者96例,未成年患者52例）作为研究对象,联合治疗前对患者血清25-羟维生素[25-hydroxyvitamin D3,25（OH)D3]水平进行检测,随机数字表法将患者分为对照组和观察组。对照组患者采用常规的治疗方法,观察组患者在其基础上使用硒酵母联合维生素D,经6个月治疗后,比较2组患者治疗前后甲状腺过氧化物酶自身抗体（thyroid peroxidase autoantibody,TPOAb）及甲状腺球蛋白抗体（thyroglobulin antibody,TgAb）水平及疗效。结果：成年患者和未成年患者治疗前25（OH）D3水平均较参考范围偏低,但未成年患者高于成年患者（P<0.05）。成年患者和未成年患者联合治疗前对照组和观察组TPOAb以及TgAb水平差异无统计学意义（P>0.05）,经6个月治疗后观察组TPOAb和TgAb水平显著低于对照组（P<0.05）,同时观察组患者治疗效果显著高于对照组（P<0.05）。结论：对HT患者在常规治疗基础上应用硒酵母联合维生素D可以有效降低成年和未成年患者的TPOAb和TgAb水平,疗效显著,值得临床推广应用。
谷巍, 侯丽萍, 李晓龙, 耿建林 . 硒酵母联合维生素D对不同年龄分层的桥本甲状腺炎患者甲状腺相关抗体水平的影响[J]. 内科理论与实践, 2021 , 16(06) : 392 -396 . DOI: 10.16138/j.1673-6087.2021.06.005
Objective To investigate the effect of selenium yeast combined with vitamin D on thyroid related antibody levels in Hashimoto thyroiditis (HT) patients at different ages. Method In this study, 148 patients with HT (96 adults and 52 minors) were selected from December 2017 to December 2019. The patients were divided into control group and observation group. The patients in the control group were treated with routine methods and the observation group of patients used selenium yeast and vitamin D besides routine treatment. After 6 months, the levels of thyroid peroxidase autoantibody (TPOAb) and thyroglobulin antibody (TgAb) before and after treatment were compared between two groups. Results Serum 25-hydroxyvitamin D3 [25(OH) D3] levels were detected in both adults and minors before combined treatment. The average 25(OH) D3 level in 2 groups before treatment was lower than normal, while the 25(OH) D3 level in minors was higher than that in adults (P<0.05). There was no significant difference in TPOAb and TgAb in control group and the observation group before treatment(P>0.05). The levels of TPOAb and TgAb in the observation group were significantly lower than those in the control group(P<0.05), in addition, the treatment effect of the observation group was significantly higher than that of the control group(P<0.05). Conclusions The treatment of HT with selenium yeast combined with vitamin D on the basis of routine treatment can effectively reduce the TPOAb and TgAb level in adult and minor patients. The therapeutic effect is remarkable and has application value in the clinic.
| [1] | Zaletel K, Gaberšôcek S. Hashimoto’s thyroiditis: from genes to the disease[J]. Curr Genomics, 2011, 12(8): 576-588. |
| [2] | Caturegli P, De Remigis A, Rose NR. Hashimoto thyroiditis: clinical and diagnostic criteria[J]. Autoimmun Rev, 2014, 13(4-5): 391-397. |
| [3] | Zimmermann MB, Boelaert K. Iodine deficiency and thyroid disorders[J]. Lancet Diabetes Endocrinol, 2015, 3(4): 286-295. |
| [4] | Wang W, Mao J, Zhao J, et al. Decreased thyroid peroxidase antibody titer in response to selenium supplementation in autoimmune thyroiditis and the influence of a selenoprotein P gene polymorphism: a prospective, multicenter study in China[J]. Thyroid, 2018, 28(12): 1674-1681. |
| [5] | 刘杉, 熊丰, 刘恩梅, 等. 1,25(OH)2D3干预实验性自身免疫性甲状腺炎TH1/TH2细胞失衡的研究[J]. 南方医科大学学报, 2010, 30(7): 1573-1576. |
| [6] | 郑筱萸. 中药新药临床研究指导原则(试行)[M]. 北京: 中国医药科技出版社, 2002: 226-233. |
| [7] | 中华医学会内分泌学分会《中国甲状腺疾病诊治指南》编写组. 中国甲状腺疾病诊治指南——甲状腺炎[J]. 中华内科杂志, 2008, 47(9): 784-788. |
| [8] | 方露, 朱武飞, 廖翔宇, 等. 桥本氏甲状腺炎患者年龄、性别分布及自身免疫抗体水平分析[J]. 微循环学杂志, 2020, 30(1): 69-72. |
| [9] | 中华医学会, 中华医学会杂志社, 中华医学会全科医学分会, 等. 甲状腺功能减退症基层诊疗指南(2019年)[J]. 中华全科医师杂志, 2019, 18(11): 1022-1028. |
| [10] | 汪岛, 王曙. 硒与甲状腺:密不可分的联系[J]. 内科理论与实践, 2011, 6(5): 397-400. |
| [11] | 王清华, 余霄龙, 王娈, 等. 亚硒酸钠对桥本甲状腺炎患者血清甲状腺过氧化物酶抗体滴度及氧化应激水平的影响[J]. 中华内分泌代谢杂志, 2017, 33(8): 668. |
| [12] | Rostami R, Nourooz-Zadeh S, Mohammadi A, et al. Serum selenium status and its interrelationship with serum biomarkers of thyroid function and antioxidant defense in Hashimoto’s thyroiditis[J]. Antioxidants (Basel), 2020, 9(11): 1070. |
| [13] | 任珍, 张薇, 王晓光. 左甲状腺素钠联合硒酵母对桥本甲状腺炎甲状腺功能减退的疗效分析[J]. 中国慢性病预防与控制, 2017, 25(1): 60-62. |
| [14] | de Farias CR, Cardoso BR, de Oliveira GM, et al. A randomized-controlled, double-blind study of the impact of selenium supplementation on thyroid autoimmunity and inflammation with focus on the GPx1 genotypes[J]. J Endocrinol Invest, 2015, 38(10): 1065-1074. |
| [15] | Wichman J, Winther KH, Bonnema SJ, et al. Selenium supplementation significantly reduces thyroid autoantibody levels in patients with chronic autoimmune thyroiditis[J]. Thyroid, 2016, 26(12): 1681-1692. |
| [16] | 王清华, 余霄龙, 王娈, 等. 亚硒酸钠对桥本甲状腺炎患者血清甲状腺过氧化物酶抗体滴度及氧化应激水平的影响[J]. 中华内分泌代谢杂志, 2017, 33(8): 668. |
| [17] | 高莹, 刘明明, 修瑞娟. 桥本甲状腺炎的免疫学发病机制进展[J]. 内科理论与实践, 2013, 8(6): 392-396. |
| [18] | Krysiak R, Szkróbka W, Okopień B. The effect of vitamin D on thyroid autoimmunity in levothyroxine-treated women with Hashimoto’s thyroiditis and normal vitamin D status[J]. Exp Clin Endocrinol Diabetes, 2017, 125(4): 229-233. |
| [19] | 侯丽萍, 耿建林, 谷巍, 等. 维生素D3对实验性自身免疫性甲状腺炎Th1/Th2细胞平衡和MCP-1/CCR2信号的影响[J]. 重庆医科大学学报, 2021, 46(08): 921-926. |
| [20] | D’Aurizio F, Villalta D, Metus P, et al. Is vitamin D a player or not in the pathophysiology of autoimmune thyroid diseases?[J]. Autoimmun Rev, 2015, 14(5): 363-369. |
| [21] | Bozkurt NC, Karbek B, Ucan B, et al. The association between severity of vitamin D deficiency and Hashimoto’s thyroiditis[J]. Endocr Pract, 2013, 19 (3): 479-484. |
| [22] | Liontiris MI, Mazokopakis EE. A concise review of Hashimoto thyroiditis (HT) and the importance of iodine, selenium, vitamin D and gluten on the autoimmunity and dietary management of HT patients. Points that need more investigation[J]. Hell J Nucl Med, 2017, 20(1): 51-56. |
/
| 〈 |
|
〉 |
