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硒调节自身免疫性甲状腺疾病自身抗体的效果
Effect of treatment with selenium on the level of auto-antibodies in patients with autoimmune thyroid diseases

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DOI:
作者:
肖玲， 姜文娟， 史良凤， 何双涛， 黎丹凤， 张进安
XIAOLing , JIANGWenjuan , SHILiangfeng，HEShuangtao, LIDanfeng, ZHANGJinan
作者单位:
复旦大学附属金山医院
Jinshan Hospital of Fudan University
关键词:
硒，Graves病，桥本甲状腺炎，甲状腺过氧化物酶抗体，甲状腺球蛋白抗体，甲状腺受体抗体
selenium，Graves Disease，Hashimoto’s thyroiditis，TPOAb，TGAb，TRAb
摘要:
目的 评价硒酵母治疗对自身免疫性甲状腺疾病中甲状腺自身抗体的调节效果。方法 选取2013年6月-2016年1月期间在复旦大学附属金山医院内分泌科规律就诊随访的Graves病患者64例及桥本甲状腺炎患者77例。根据患者所接受治疗方案分为常规治疗对照组和硒补充治疗组（200ug/日）。并观察治疗后3月、6月、12月及18-24月时甲状腺自身抗体的变化，比较组间抗体水平的差异。结果 1、Graves病及桥本氏甲状腺炎硒补充治疗组甲状腺自身抗体均随着治疗时间延长而降低，而常规治疗组仅TRAb随治疗时间延长明显下降，TPOAb，TGAb则变化不明显。2、桥本甲状腺炎患者中硒补充治疗6个月后TPOAb，TGAb抗体明显下降。硒补充治疗6个月时TPOAb下降了32%，12个月时下降了48%，18-24月时达61%。硒补充治疗6月时TGAb下降52%，12月下降66%，18-24月时达78%。3、两组Graves病患者TRAb经治疗后均有明显下降，而硒补充治疗组抗体下降更明显，治疗6个月后两组间TRAb下降出现统计学差异。硒补充治疗6个月时TRAb下降64%，12个月下降77%，18-24月时达88%。排除甲巯咪唑治疗对TRAb的影响后，仍然可以得出硒补充治疗有降低TRAb的作用。结论 每日200ug硒酵母治疗对降低Graves病的TRAb浓度及桥本甲状腺炎患者的TPOAb，TGAb均有明显效果。
Objective To examine the effect of selenium treatment on auto-antibodies in autoimmune thyroid diseases. Methods 64 Graves’ disease patients and 77 Hashimoto’s thyroiditis patients who came to the endocrinology department of Jinshan Hospital affiliated to Fudan University during 2013,6 to 2016,1 were recruit. These patients were allocated into two groups according to the treatment they recieved: the selenium supplement（200ug selenium everyday） treatment group and the control treatment group. We compared the three auto-antibodies levels in two groups at the end of the third month，the sixth months，the twelve month and the eighteen to twenty-four months of treatment. Results 1.Three auto-antibodies decreased in the selenium supplement treatment group while only TRAb decreased in the control group. 2.TPOAb and TGAb decreased obviously after six months of treatment of selenium supplement. TPOAb decreased by 32%, 48% and 61% after six months, twelfth months and eighteen to twenty-four months of treatment of selenium supplement，respectively. TGAb decreased by 52%, 66% and 78% after six months, twelve months and eighteen to twenty-four months of treatment of selenium supplement， respectively. 3. TRAb decreased in both treatment groups while decreased greatly in the selenium supplement group after six months of treatment. TRAb decreased by 64%, 77% and 88% after six months, twelve months and eighteen to twenty-four months of treatment of selenium supplement，respectively. Selenium may decrease TRAb levels excluding the methimazole effect on TRAb. Conclusions 200ug selenium perday supplement was effective in decreasing anti-thyroid antibodies in autoimmune thyroid diseases.

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