左旋甲状腺素对甲减患者治疗效果及血脂水平影响.docxVIP

左旋甲状腺素对甲减患者治疗效果及血脂水平影响 荣秀花 罗婉莹 曹敏 李小景 ［摘 要］目的观察左旋甲状腺素对甲减患者的疗效及血脂水平影响。方法 92例原发性甲减患者随机分为观察组和对照组各46例，两组分別给予左旋甲状 腺素和甲状腺片口服，逐渐增加剂量，并根据甲状腺功能检查结果调整剂量。6 月后比较两组的疗效和不良反应。结果治疗后两组的TSH水平均显箸下降,T3、 T4、FT3、FT4水平均显著升高；组间比较差异有统计学意义(Plt;0.05)；两组 患者治疗后TG、TC、LDL?C水平均明显下降(Plt;0.05), HDL-C水平无明显变 化，组间比较无统计学差异(Pgt；0.05)o治疗过程中观察组的不良反应发生率 显著低于对照组(Plt;0.05)o结论 左旋甲状腺素治疗甲状腺功能减退疗效显著, 安全性良好，不良反应少，同时能够纠正血脂代谢异常，具有重要临床价值。 ［关键词］甲状腺功能减退症 左旋甲状腺素 甲状腺片 血脂 The In flue nee of Levothyroxi ne on Blood Lipid Levels among Patients with Hypothyroidism Rong Xiuhua Luo Wanying Cao Min Li Xiaojing Abstract: Objective To observe the in flue nee of levothyroxi ne on the blood lipid levels among patients with hypothyroidism. Methods 92 cases of patients with hypothyroidism were randomly divided into two groups. The observed group was treated by levothyroxine while the control group was treated by thyroxine tablets. The dosage was gradually in creased and the dose was adjusted according to thyroid function. The clinical effects and adverse reactions after 6 months were compared. Results The level of TSH were reduced and the levels of T3, T4, FT3, FT4 were increased, with significant difference (Plt;0.05); The level of TG, TC, LDL-C were reduced than that of before treatment (P lt;0.05); There were no significant differenee in the reduced levels of HDL-C (Pgt;0.05); The rate of adverse reactions were lower than that of the control group (Plt;0.05). Conclusion Levothyroxine can improve the clinical effects of patients with hypothyroidism. It has good security, with fewer adverse reactions, and can correct abnormal lipid metabolism, which is important in clinical value. Key word: hypothyroidism; levothyroxine; thyroxine tablets; blood lipid D0l:10.3760/cma.j.issn.0376-2491.2014.24.036 作者单位：523110,广东东莞市，东莞市东华医院 甲状腺功能减退症简称甲减，是甲状腺激素合成、分泌或效应不足而导致的 一种全身低代谢综合征。我国临床甲减的患病率为1%左右，多见于女性［1］。95% 以上的甲减是甲状腺病变而引起的，随着甲状腺疾病发生率的增加，甲减的发生 率也呈上升的趋势。近年来发现，甲减患者常伴有血脂代谢异常。左旋甲状腺素 是临床上甲减替代治疗的主要药物，本研究观察了左旋甲状腺素对甲减患者的疗 效及对患者血脂代谢的影响，现报道如下： 1资料与方法 1.1 一