小剂量l-t4对甲状腺良性小结节生化指标水平的影响及疗效影响因素

doi:10.3969/j.issn.1006-6233.2020.02.002

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Abstract Objective: To investigate the effect of low-dose l-t4 on the biochemical markers of benign small nodules and the influencing factors. Methods: From January 2016 to January 2018, 78 patients with benign thyroid nodules were enrolled in the endocrinology department of our hospital. They were divided into observation group and control group according to the random number table method. Small doses were taken for the observation group. Left thyroid hormone (l-t4) treatment, the course of treatment is 1 year, no drug treatment for the control group, only clinical observation and follow-up. TSH, JV, JD3, small nodule diameter and thyroid-stimulating hormone levels and serum free thyroxine (FT4) were measured every 3 months. The detection is performed in 4 cycles horizontally. At the same time, a total study of 39 patients in the observation group was conducted to investigate the effect of gender and age on the diameter of small thyroid nodules in patients. Results: After 12 months of treatment, the thyroid volume (8.52±8.68) cm³ and the maximum nodule cross-section diameter (47.88±8.54) mm in the observation group were significantly smaller than those in the control group (13.16±9.88) cm³ and (63.48±10.24) mm, and the difference was statistically significant (P<0.05). After 12 months, the diameter of small nodules in the observation group (4.84±1.80) mm was significantly lower than that in the control group (6.33±1.91) mm, and the difference was statistically significant (P<0.05). After 12 months of treatment, the level of thyrotropic hormone (0.36±0.14) mIU/L in the observation group was significantly lower than that in the control group (1.86±0.78) mIU/L, and serum free thyroxine (26.24±4.04) pmoL/L was significantly higher than that in the control group (16.88±3.52) pmoL/L, the difference was statistically significant (P<0.05). After 12 months, the diameter of small nodules and TSH of the female patients in the observation group were (4.32±1.76) mm and (0.31±0.10) mIU/L, respectively, which were significantly lower than those of the male patients (5.62±1.76) mm and (0.46±0.15) mIU/L, and the difference was statistically significant (P<0.05). FT4 was (29.61±5.42) pmoL/L, which was significantly higher than (21.26±4.37) pmoL/L in men, and the difference was statistically significant (P<0.05). The diameter of small nodules and TSH of patients <45 years old were (4.94±1.26) mm and (0.34±0.13) mIU/L, respectively, and the values of (5.86±1.58) mm and (0.49±0.15) mIU/L of patients ≥45 years old were significantly reduced (P<0.05). FT4 was (28.81±3.07) pmoL/L, which was significantly lower than that of male (22.60±4.00), and the difference was statistically significant (P<0.05). Conclusion: Low-dose l-t4 can effectively control the thyroid benign small nodule biochemical index to inhibit the secretion of TSH and increase the FT4 level and control the growth of benign small nodules. It is more effective for female patients and patients <45 years old.

Key words： Small dose l-t4 Benign small nodules Biochemical indicators Thyroid stimulating hormone Serum free thyroxine

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2020.02.002 OR http://www.hbyxzzs.cn/EN/Y2020/V26/I2/181