内科

目的探讨甲巯咪唑联合硒酵母治疗对自身免疫性甲状腺病（AITD）伴甲状腺功能亢进患者甲状腺功能、甲状腺抗体水平及免疫功能的影响。方法选取2018年9月至2020年12月在我院就诊的AITD伴甲状腺功能亢进患者83例为研究对象，采用随机数字法分为对照组（41例）和观察组（42例）。对照组患者给予甲巯咪唑治疗，观察组患者在对照组的基础上给予硒酵母治疗，疗程3个月。比较两组患者治疗前后的甲状腺功能、甲状腺抗体水平以及免疫功能。结果治疗前，两组患者的促甲状腺激素（TSH）、游离甲状腺素（FT4）、游离三碘甲状腺原氨酸（FT3）水平比较，差异无统计学意义（P＞0.05）。治疗3个月后，两组患者的TSH水平均显著升高，FT4、FT3水平均显著降低；但两组患者的TSH、FT4、FT3水平比较，差异无统计学意义（P＞0.05）。治疗前，两组患者的抗甲状腺球蛋白抗体（TGAb）、促甲状腺素受体抗体（TRAb）、抗甲状腺过氧化物酶抗体（TPOAb）水平比较，差异无统计学意义（P＞0.05）；治疗3个月后，两组患者的TGAb、TRAb、TPOAb水平均显著降低，观察组患者的水平显著低于对照组，差异有统计学意义（P＜0.05）。治疗前，两组患者的CD4+、CD8+、CD4+/CD8+水平比较，差异无统计学意义（P＞0.05）；治疗3个月后，观察组患者的CD4+、CD4+/CD8+水平显著高于对照组，CD8+水平显著低于对照组，差异有统计学意义（P＜0.05）。结论甲巯咪唑联合硒酵母治疗自身免疫性甲状腺病伴甲状腺功能亢进患者，可显著降低患者的甲状腺抗体水平，明显改善患者的甲状腺功能及免疫功能。

ObjectiveTo investigate the effects of methimacole combined with selenium yeast on thyroid function, thyroid antibody levels and immune function in autoimmune thyroid disease (AITD) patients complicated with hyperthyroidism. MethodsAccording to the random number method, 83 AITD patients complicated with hyperthyroidism in our hospital from September 2018 to December 2020 were divided into two groups. With a 3-month course of treatment, 41 patients in the control group were treated with methimazole, and 42 patients in the observation group were given selenium yeast treatment on the basis of the control group. The thyroid function, thyroid antibody levels and immune function were compared between the two groups before and after treatment. ResultsBefore the treatment, there were no statistically significant differences in the levels of thyroid-stimulating hormone (TSH), free thyroxine (FT4) and free triiodothyronine (FT3) between the observation group and the control group (P＞0.05). After 3 months of treatment, TSH levels in both groups significantly increased, while FT4 and FT3 levels remarkably decreased. And there were no statistically significant differences in TSH, FT4 and FT3 levels between the two groups (P＞0.05). Before treatment, levels of antithyroglobulin antibody (TGAb), thyrotropin receptor antibody (TRAb), and antithyroid peroxidase antibody (TPOAb) were not significantly different between the two groups (P＞0.05). 3 months after treatment, TGAb, TRAb and TPOAb levels in both groups significantly decreased, and the levels in the observation group were lower than those in the control group , which differences were statistically significant (P＜0.05). Before the treatment, there were no statistically significant differences in CD4+, CD8+ and CD4+/CD8+ levels between both groups (P＞0.05). After 3 months of treatment, the patients in the observation group had significantly higher CD4+, CD4+/CD8+ levels and lower CD8+ level than the patients in the control group,and the differences between the two groups were statistically significant (P＜0.05). ConclusionsThe treatment of methimazole combined with selenium yeast for AITD patients with hyperthyroidism resulted in a significant reduction of thyroid antibody levels and a notable improvement of thyroid function and immune function.