硒对自身免疫性甲状腺炎患者的影响

E. A. Shabalina, V. Fadeyev
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引用次数: 1

摘要

背景:在过去的几十年里,已经进行了大量的临床研究,其中硒对甲状腺自身免疫的阳性和中性作用已经被证明。目的:本研究旨在评估硒蛋氨酸对TPO- ab升高的甲状腺功能正常患者(TPO > 100 IU/ml)和亚临床甲状腺功能减退并TPO- ab升高的患者的影响。材料与方法:选取40例甲状腺功能正常且TPO-Ab升高的患者和11例亚临床甲状腺功能减退合并TPO-Ab升高的患者作为研究对象。两组患者随机分为两组,分别给予Se 200 μg/d和动态观察组。在基线和每3个月随访时测量TSH、f. T4、f. T3、at - tpo。每3个月(12个月)随访一次甲状腺体积和回声。结果:TPO-Ab升高的甲状腺功能正常患者在整个观察期内TSH、f. T3、f. T4、AT-TPO滴度、体积及甲状腺回声性的动态变化在两组间无显著差异。亚临床甲状腺功能减退患者的ft3、ft4、AT-TPO滴度、体积及甲状腺回声在整个观察期内的动态变化在两组间也无显著差异。但随访12个月时,硒组甲状腺功能正常患者明显多于动态观察组。结论:我们的研究未能显示硒补充对甲状腺自身免疫的积极作用。
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Effects of selenium in patients with autoimmune thyroiditis
Background: In the last decades, a number of clinical studies have been conducted where both the positive and neutral effects of Se on thyroid autoimmunity have been demonstrated. Aims: The aim of our study was to assess the effects of selenmethionine among euthyroid patients with elevated TPO-Ab (TPO > 100 IU/ml) and patients with subclinical hypothyroidism and elevated TPO-Ab. Materials and methods: 40 euthyroid patients with elevated TPO-Ab and 11 patients with subclinical hypothyroidism plus elevated TPO-Ab were included in our study. Patients of both categories were randomized to recieve Se 200 μg/day or to the dynamic observation. TSH, f. T4, f. T3, AT-TPO were measured at baseline and every 3 months of follow-up. The volume and echogenicity of the thyroid were also evaluated every 3 month of follow-up period (12 month). Results: There were no significant difference between the groups on the dynamics of TSH, f. T3, f. T4, AT-TPO titers, volume and the echogenicity of the thyroid gland during the whole observational period among euthyroid patients with elevated TPO-Ab. Among the patients with subclinical hypothyroidism there were also no significant difference between the groups on the dynamics of f. T3, f. T4, AT-TPO titers, volume and the echogenicity of the thyroid gland during the whole observational period. But by the 12 month of the follow-up there were significantly more euthyroid patients in Se group compare to dynamic observation group. Conclusions: Our study, failed to show possitive effects of Se supplementation on thyroid autoimmunity.
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