海南医科大学学报

目的:探讨小剂量左甲状腺素(L-T4)治疗良性甲状腺结节的疗效。方法:将本院收治的124例良性甲状腺结节患者随机分为两组,对照组未予药物治疗,仅临床随访观察,观察组给予小剂量左甲状腺激素治疗12个月,每组各62例。每3个月检测两组促甲状腺素等生化指标水平和甲状腺结节大小变化及不良反应,随访12个月。结果:治疗后随访12个月,观察组治疗12个月后最大结节横截面直径(JD3)和甲状腺体积(JV)明显小于治疗前和对照组治疗后大小,差异具有统计学意义(P<0.05);治疗6个月后和12个月后体积明显小于对照组,差异具有统计学意义(P<0.05);治疗12个月后TSH水平明显低于治疗前和对照组治疗后水平,而FT4明显高于治疗前和对照组治疗后水平,差异均具有统计学意义(P<0.05)。结论:能够有效的抑制内源性的TSH分泌和良性甲状腺结节的生长,延缓病程发展,疗效确切。

Objective:To investigate the clinical effcts of small dose Levothyroxine suppression(L-T4)therapy for benign thyroid nodules.Methods:124cases of benign thyroid nodules were randomly divided into two groups,with 62 cases in each group.Clinical follow-up was conducted for the control groups only,while for the observation group,small dose of left thyroid hormone treatment were applied for 12 months.Changes of two thyroid stimulating hormone and other biochemical indexes,the level of thyroid nodule size and of adverse reactions were followed up and compared for 12 months.Results:The patients were followed up for 12 months.The maximum nodule cross-sectional diameter(JD3)and thyroid volume(JV)in the observation groups were smaller than that before the treatment,and also smaller than that of the control group after treatment(P<0.05).After 6months and 12 months of treatment,the size of thyroid volume were significantly less than that of the control groups(P<0.05).After treatment of 12 months,the level of TSH in the observation groups were significantly lower than that before treatment and were also lower than that of the control groups after treatment(P<0.05).FT4 of the observation group was significantly higher than that before treatment and was higher than that of the control groups after treatment(P<0.05).Conclusions:Small dose levothyroxine could effectively inhibit endogenous TSH secretion and benign thyroid nodule growth and delay the progression of the disease.The effect of small dose Levothyroxine was obvious.