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目的:观察与分析亚临床甲状腺功能减退症患者应用左旋甲状腺素治疗临床疗效及对血脂水平的影响,从而可为临床合理用药提供参考。方法:截选平阳县人民医院2013年2月-2014年8月期间64例患者,按照随机数字表法分组为对照组(六味地黄丸)与治疗组(左旋甲状腺素),各32例。统计两组临床疗效和治疗前、后血脂水平、血清FT 4(游离甲状腺素)、TSH(促甲状激素)、FT 3(游离三碘甲状腺原氨酸)变化,并观察治疗期间不良反应情况。结果:治疗组治疗总有效率为90.6%明显高于对照组53.1%,差异具有统计学意义,P<0.05。经治疗后,对照组患者各项血脂水平较治疗前比较,差异无统计学意义,P>0.05;治疗组TG、TC、LDL较治疗前明显下降,且优于对照组,差异具有统计学意义,P<0.05;然治疗组治疗前、后HDL与治疗前、对照组比较,差异无统计学意义,P>0.05。治疗后,患者血清FT4、FT3水平较治疗前显著升高,而TSH明显下降,P<0.05;治疗期间未见明显不良反应。结论:相比六味地黄丸来说,应用左旋甲状腺素治疗亚临床甲状腺功能减退症患者疗效显著且可有效降低患者血脂水平。
Objective: To observe and analyze the clinical efficacy of levothyroxine in patients with subclinical hypothyroidism and its effect on blood lipid levels, which may provide a reference for clinical rational drug use. Methods: A total of 64 patients in Pingyang County People’s Hospital from February 2013 to August 2014 were randomly divided into control group (Liuweidihuangwan) and treatment group (levothyroxine), 32 cases in each group. The clinical curative effect and serum lipid level, serum FT 4 (free thyroxine), TSH (thyrotropin), FT 3 (free triiodothyronine) in the two groups were statistically analyzed before and after treatment. The adverse reactions during the treatment were observed. Results: The total effective rate of the treatment group was 90.6%, significantly higher than that of the control group (53.1%), the difference was statistically significant (P <0.05). After treatment, the control group of patients with lipid levels compared with before treatment, the difference was not statistically significant, P> 0.05; treatment group TG, TC, LDL decreased significantly than before treatment, and better than the control group, the difference was statistically significant , P <0.05; However, there was no significant difference in HDL before and after treatment between the treatment group and the control group (P> 0.05). After treatment, the levels of serum FT4 and FT3 in patients were significantly higher than those before treatment, while TSH was significantly decreased, P <0.05; no obvious adverse reactions were observed during the treatment. Conclusion: Compared with Liuweidihuangwan, the application of levothyroxine in subclinical hypothyroidism has significant curative effect and can effectively reduce the level of blood lipid in patients.