| Object In this paper,the efficacy of selenium yeast in the treatment of hashimoto's thyroiditis(HT)and the predictive value of TPOAb titer in the treatment of HT efficacy were discussed.Methods This study adopts a randomized,controlled and prospective clinical approach.HT patients in the endocrine outpatient clinic of Qingdao municipal hospital [including normal thyroid function(including subclinical hypothyroidism)HT patients and hypothyroidism HT patients] 138 cases were observed.According to the randomization principle,it was divided into the selenium yeast treatment group and the control group,and the two groups were divided into the hypothyroidism selenium yeast treatment subgroup and control subgroup.Observed 6 months,after 0? 6 month,clinical symptoms were assessed using the sf-36 health questionnaire for all observers,after 0? 3? 6 months,to detect serum TPOAb titer ?thyroid-stimulating hormone(TSH)?free thyroxine(FT4)and the levothyroxine substitution dose of the patients in the hypothyroidism subgroup.The first part of study,by comparing the two groups of patients before and after treatment the observation indexes of change,statistical software was used for statistical analysis,to evaluate the efficacy of selenium yeast in HT treatment,the second part of the study,the selenium yeast treatment group was stratified by TPOAb,the clinical symptom score,TPOAb titer change,and the levothyroxine substitution dose of hypothyroidism subgroup of the patients with HT were evaluated.statistical software was used for statistical analysis,to explore the diagnosis and treatment TPOAb drop degree of selenium yeast HT predictive value,to evaluate the predictive value of TPOAb titer on the efficacy of selenium yeast in treating HT,and to determine the best pointcut of TPOAb titer of HT with selenium yeast.Result(1)Comparison of clinical symptom scores of sf-36 health survey in each group After 6 months treatment,the physical functioning,role physical,general health,vitality,social functioning,role emotional,mental health score of selenium yeast treatment group all higher than the control group,difference was statistical significant(P<0.05);there were statistically significant differences in the treatment of hypothyroidism selenium yeast treatment subgroup and hypothyroidism control subgroup(P<0.05).;there was no statistically significant difference between the normal thyroid function selenium yeast treatment subgroup and normal thyroid function control subgroup(P>0.05).(2)Comparison of TPOAb titer in two groups and subgroups After 6 months treatment,TPOAb titer of hypothyroidism selenium yeast treatment subgroup was lower than before treatment,difference was statistical significant(P<0.05);TPOAb titer of hypothyroidism control subgroup was higher than before treatment,difference was not statistical significant(P>0.05).At the end of the observation,the TPOAb titer of hypothyroidism selenium yeast treatment subgroup was lower than the hypothyroidism control subgroup,and the difference was statistically significant(P<0.05).After 6 months treatment,TPOAb titer of normal thyroid function selenium yeast treatment subgroup was lower than before treatment,the difference was statistically significant(P<0.05),the TPOAb titer of normal thyroid function control subgroup was higher than the control subgroup,and the difference was not statistically significant(P>0.05).At the end of the observation,the TPOAb titer of normal thyroid function selenium yeast treatment subgroup was lower than the normal thyroid function control subgroup,and the difference was statistically significant(P<0.05).After 6 months treatment,TPOAb titer of selenium yeast treatment group was lower than before treatment,difference was statistical significant(P<0.05);TPOAb titer of control group was higher than before treatment,difference was not statistical significant(P>0.05).At the end of the observation,TPOAb titer of selenium yeast treatment group was lower than control group,difference was statistical significant(P<0.05).(3)Comparison of TSH and FT4 change between selenium yeast treatment group and control group After 6 months of treatment,TSH of selenium yeast treatment group and control was lower than before treatment,FT4 of selenium yeast treatment group and control was higher than before treatment,difference were not statistical significant(P>0.05).At the end of the observation,TSH of selenium yeast treatment group was lower than control group,FT4 of selenium yeast treatment group was higher than control group,difference were not statistical significant(P>0.05).(4)Comparison of levothyroxine alternative dose change in hypothyroidism subgroup in the two groups After 6 months of treatment,the levothyroxine alternative dose of selenium yeast treatment subgroup was lower than before treatment.the levothyroxine alternative dose of the control subgroup was higher than before treatment,the difference were not statistically significant(P>0.05).At the end of the observation,the levothyroxine alternative dose of selenium yeast treatment subgroup was lower than the control subgroup,and the difference was statistically significant(P<0.05)2 The predictive value of TPOAb titer on the efficacy of selenium yeast in treatment HT(1)TPOAb titer of selenium yeast treatment group was stratified according to basic antibody titer,after 6 months of treatment: TPOAb>500IU/ml,TPOAb titer was lower than before treatment,the diffrerence was statistically significant(P<0.05);TPOAb?500IU/ml,TPOAb titer was lower than before treatment,and the difference was not statistically significant(P>0.05).The patients in the selenium yeast treatment group were divided into two groups: >500IU/ml,and ?500IU/ml,and the clinical score and the levothyroxine substitution dose were statistically analyzed.(2)Sf-36 health survey summary score comparison TPOAb>500IU/ml,After 6 months treatment,the role physical,general health,vitality,social functioning,role emotional,mental health score of selenium yeast treatment subgroup higher than the control subgroup,difference was statistical significant(P<0.05);TPOAb?500IU/ml,After 6 months treatment,the role physical score of selenium yeast treatment subgroup higher than the control subgroup,difference was statistical significant(P<0.05).(3)Levothyroxine alternative dose change in hypothyroidism subgroup TPOAb> 500IU/ml,After 6 months of treatment,the levothyroxine alternative dose of hypot hyroidism selenium yeast treated subgroup was lower than before treatment,the difference was statistically significant(P<0.05);the levothyroxine alternative dose of the hypothyroidism control subgroup was higher than before treatment,the difference was not statistically significant(P>0.05);At the end of the observation,the levothyroxine alternative dose of hypothyroidism selenium yeast treated subgroup was lower than the hypothyroidism control subgroup,and the difference was statistically significant(P<0.05);TPOAb?500IU/ml,after 6 months of treatment,levothyroxine alternative dose of hypothyroidism selenium yeast treatment subgroup and hypothyroidism control subgroup higher than before treatment,the difference was not statistically significant(P>0.05);at the end of the observation,hypothyroidism selenium yeast treatment subgroup levothyroxine alternative dose lower than hypothyroidism control subgroup the difference was not statistically significant(P>0.05).Conclusion After 6 months,the treatment of selenium supplementation,this study was conducted to study the the improvement of health-related quality of life,the decrease TPOAb titer and levothyroxine alternative dose in hypothyroidism HT patients,there was no significant effect of selenium supplementation on thyroid function in selenium yeast treatment group.TPOAb titer of was stratified according to basic antibody titer,in TPOAb>500IU/ml,In the HT population,the improvement of health-related quality of life was more significant,the levothyroxine alternative dose decrease significantly,in TPOAb>500IU/ml,maybe best curative effect of selenium yeast treatment for HT.Meaning In this study,patients with HT were supplemented with selenium yeast,the results showed that selenium yeast is effective in treating HT and in TPOAb>500IU/ml,more significant effect of selenium yeast for HT,this has important clinical guiding value for the treatment of HT patients. |
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