中华核医学与分子影像杂志
中華覈醫學與分子影像雜誌
중화핵의학여분자영상잡지
Chinese Journal of Nuclear Medicine and Molecular Imaging
2015年
4期
265-267
,共3页
袁耿彪%范永增%严清波%王玉婵%杨鑫
袁耿彪%範永增%嚴清波%王玉嬋%楊鑫
원경표%범영증%엄청파%왕옥선%양흠
甲状腺功能减退症%甲状腺素%用药计划表
甲狀腺功能減退癥%甲狀腺素%用藥計劃錶
갑상선공능감퇴증%갑상선소%용약계화표
Hypothyroidism%Thyroxine%Drug administration schedule
目的 比较晚间与早间服用L-T4对甲状腺功能低下(简称甲低)患者的甲状腺激素水平的影响.方法 对17例接受L-T4替代治疗的原发性甲低患者进行前瞻性分析,分别于早间服用L-T42个月后和改为晚间服用L-T42个月后测定TSH、FT3、FT4、三酰甘油、胆固醇、白蛋白、肌酐水平及心率.采用配对秩和检验或配对t检验比较2次测定指标的差异;采用Pearson相关分析法分析TSH变化与FT3、FT4变化的相关性.结果 17例甲低患者早间服药后和改为晚间服药后,TSH、FT3、FT4分别为(12.10±7.19)比(3.90±3.47) mU/L、(4.14±0.86)比(5.24±1.11) pmol/L、(12.72±4.40)比(18.48±2.87)pmol/L,前后差异均有统计学意义(t=6.371、-3.166、-5.435,均P＜0.01);TSH下降(8.20±5.31) mU/L,FT3上升(1.09±1.42) pmol/L,FT4上升(5.76±4.37) pmol/L,TSH下降与FT3、FT4上升之间无相关性(r=0.12、0.22,均P＞0.05);2次测定的三酰甘油、胆固醇、白蛋白、肌酐水平及心率差异均无统计学意义(t=0.240、0.017,z=0,t=-0.610、1.588,均P＞0.05).结论 服用L-T4时间由早间改为晚间后,可以降低甲低患者TSH水平,提高FT3、FT4的水平;既可以保持甲状腺激素水平的稳定,又不需要增加L-T4的剂量.
目的 比較晚間與早間服用L-T4對甲狀腺功能低下(簡稱甲低)患者的甲狀腺激素水平的影響.方法 對17例接受L-T4替代治療的原髮性甲低患者進行前瞻性分析,分彆于早間服用L-T42箇月後和改為晚間服用L-T42箇月後測定TSH、FT3、FT4、三酰甘油、膽固醇、白蛋白、肌酐水平及心率.採用配對秩和檢驗或配對t檢驗比較2次測定指標的差異;採用Pearson相關分析法分析TSH變化與FT3、FT4變化的相關性.結果 17例甲低患者早間服藥後和改為晚間服藥後,TSH、FT3、FT4分彆為(12.10±7.19)比(3.90±3.47) mU/L、(4.14±0.86)比(5.24±1.11) pmol/L、(12.72±4.40)比(18.48±2.87)pmol/L,前後差異均有統計學意義(t=6.371、-3.166、-5.435,均P＜0.01);TSH下降(8.20±5.31) mU/L,FT3上升(1.09±1.42) pmol/L,FT4上升(5.76±4.37) pmol/L,TSH下降與FT3、FT4上升之間無相關性(r=0.12、0.22,均P＞0.05);2次測定的三酰甘油、膽固醇、白蛋白、肌酐水平及心率差異均無統計學意義(t=0.240、0.017,z=0,t=-0.610、1.588,均P＞0.05).結論 服用L-T4時間由早間改為晚間後,可以降低甲低患者TSH水平,提高FT3、FT4的水平;既可以保持甲狀腺激素水平的穩定,又不需要增加L-T4的劑量.
목적 비교만간여조간복용L-T4대갑상선공능저하(간칭갑저)환자적갑상선격소수평적영향.방법 대17례접수L-T4체대치료적원발성갑저환자진행전첨성분석,분별우조간복용L-T42개월후화개위만간복용L-T42개월후측정TSH、FT3、FT4、삼선감유、담고순、백단백、기항수평급심솔.채용배대질화검험혹배대t검험비교2차측정지표적차이;채용Pearson상관분석법분석TSH변화여FT3、FT4변화적상관성.결과 17례갑저환자조간복약후화개위만간복약후,TSH、FT3、FT4분별위(12.10±7.19)비(3.90±3.47) mU/L、(4.14±0.86)비(5.24±1.11) pmol/L、(12.72±4.40)비(18.48±2.87)pmol/L,전후차이균유통계학의의(t=6.371、-3.166、-5.435,균P＜0.01);TSH하강(8.20±5.31) mU/L,FT3상승(1.09±1.42) pmol/L,FT4상승(5.76±4.37) pmol/L,TSH하강여FT3、FT4상승지간무상관성(r=0.12、0.22,균P＞0.05);2차측정적삼선감유、담고순、백단백、기항수평급심솔차이균무통계학의의(t=0.240、0.017,z=0,t=-0.610、1.588,균P＞0.05).결론 복용L-T4시간유조간개위만간후,가이강저갑저환자TSH수평,제고FT3、FT4적수평;기가이보지갑상선격소수평적은정,우불수요증가L-T4적제량.
Objective To compare the effect of L-T4 taken in the morning vs bedtime on serum thyroid hormone in patients with hypothyroidism.Methods Seventeen patients with primary hypothyroidism were prospectively included.They took L-T4 in the morning for 2 months followed by L-T4 taken during the bedtime for 2 months.Thyroid hormone levels and cholesterol,triglyceride,albumin,creatinine and heart rate were measured.Wilcoxon test and paired t test were used to compare the data.The correlation between the changes of TSH and FT3,FT4 was analyzed respectively by Pearson correlation analysis.Results TSH,FT3,FT4 were:(12.10±7.19) vs (3.90±3.47) mU/L,(4.14±0.86) vs (5.24±1.11) pmol/L,(12.72± 4.40) vs (18.48±2.87) pmoL/L for L-T4 taken in the morning and during the bedtime respectively (t value:6.371,-3.166,-5.435,all P＜0.01).There was no correlation between the changes of TSH and FT3,FT4(r=O.12,0.22,both P＞0.05),respectively.The averaged changes were (8.20±5.31) mU/L,(1.09± 1.42) pmol/L and (5.76±4.37) pmol/L.Triglyceride,cholesterol,albumin,creatinine levels and heart rate were not significantly different with L-T4 taken in the morning and during bedtime (t=0.240,0.017;z=0;t=-0.610,1.588,all P＞0.05).Conclusions L-T4 taken during the bedtime by patients with hypothyroidism would reduce TSH and increase FT3,FT4 levels.This method can maintain the stability of TSH level with no need to increase the dose.
