硒酵母对初发Graves病抗甲状腺药物治疗疗程的影响

高芸 贾冰 潘懿

摘 要：目的 探讨在初发Graves病患者抗甲状腺药物治疗中硒酵母对疗程的影响。方法 选取2012年2月～2015年2月63例初发Graves病患者，随机分为两组，对照组32例和加硒组31例，对照组给予常规抗甲状腺药物治疗，加硒组在对照组治疗基础上加用硒酵母片治疗，观察患者甲状腺功能，TSH、TRAb正常时间及药物治疗的差异。结果 加用硒酵母治疗组甲状腺功能正常和TSH正常时间较对照组短，差异有统计学意义（P<0.05），加硒组TRAb正常时间及治疗疗程较对照组缩短，差异有统计学意义（P<0.05）。结论 硒酵母能使初发Graves病患者抗甲状腺药物治疗中更快恢复甲状腺功能，缩短TRAb转阴时间及抗甲状腺药物治疗的疗程。

关键词：硒酵母；Graves病；抗甲状腺药物

中图分类号：R581.1 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.09.044

文章编号：1006-1959（2018）09-0140-03

Abstract：Objective To investigate the effect of selenium yeast on the course of treatment in patients with primary Graves disease anti-thyroid drugs.Methods 63 patients with primary Graves disease from February 2012 to February 2015 were randomly divided into two groups，32 cases in the control group and 31 cases in the selenium supplemented group.The control group was treated with conventional antithyroid drugs，and the selenium group was treated with selenious yeast tablets on the basis of the control group.The thyroid function，the normal time of TSH and TRAb and the difference of drug treatment were observed.Results Compared with the control group，the normal thyroid function and the normal time of TSH were shorter in the selenium yeast-treated group，and the difference was statistically significant（P<0.05），the normal time and treatment course of TRAb in selenium supplemented group were shorter than those in control group，and the difference was statistically significant（P<0.05）.Conclusion Selenium yeast can restore thyroid function faster in patients with primary Graves disease during anti-thyroid drug treatment，shorten the time of TRAb negative turn and anti-thyroid drug treatment.

Key words：Selenium yeast；Graves disease；Anti-thyroid drug

格雷夫斯病又稱毒性弥漫性甲状腺肿、Graves病（toxicdiffusegoiter），是一种器官特异性自身免疫性疾病，是引起甲状腺功能亢进症的最主要的病因[1]。抗甲状腺药物治疗是Graves病主要的治疗方法之一，抗甲状腺药物为硫脲衍生物，甲巯咪唑或丙硫氧嘧啶，但疗程很长，停药后复发率较高。硒与甲状腺关系密切，其所具有的抗氧化作用可保护甲状腺免受氧化损伤。本研究是一个前瞻性对照临床研究，旨在探讨硒对初发Graves病患者抗甲状腺药物治疗疗程的影响，具体分析如下。

1资料与方法

1.1一般资料 选取2012年2月～2015年2月在原子医学研究所附属江原医院内分泌科门诊及住院检查确诊的初发Graves病患者63例，本次研究经过医院伦理委员会批准。甲状腺功能高于正常，无抗甲状腺药物副作用，甲状腺0～Ⅱ度肿大，剔除后续放射性碘治疗和手术治疗，按数字表法随机分为对照组和加硒组，对照组32例，男性6例，女性26例，年龄22～64岁，平均年龄……