ketendoКлиническая и экспериментальная тиреоидологияClinical and experimental thyroidology1995-54722310-3787Endocrinology Research Centre10.14341/ket2016416-30ketendo-8707Research ArticleОригинальные исследованияOriginal StudiesЭффекты селена в составе консервативной терапии болезни ГрейвсаEffects of selenium in patients with Graves’ disease treated with antithyroid drugsШабалинаЕлена АлександровнаShabalinaElena A.

аспирант кафедры эндокринологии лечебного факультета

MD

shabalinaelena@mail.ruhttps://orcid.org/0000-0002-3026-6315ФадеевВалентин ВикторовичFadeyevValentin V.

д.м.н., профессор, член-корр. РАН

MD, PhD, Professor

walfad@mail.ru<p>ФГАОУ ВО Первый МГМУ им. И.М. Сеченова Минздрава России</p>Россия<p>I.M. Setchenov First Moscow State Medical University</p>Russian Federation2016070620171241630Copyright &#x00A9; Шабалина Е.А., Фадеев В.В., 20162016Шабалина Е.А., Фадеев В.В.Shabalina E.A., Fadeyev V.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.cet-endojournals.ru/jour/article/view/8707

Несмотря на противоречивые результаты недавно проведенных исследований селена (Se) при болезни Грейвса (БГ), адъювантная роль микроэлемента при данном заболевании продолжает исследоваться.

Целью данной работы являлось изучение эффектов селенметионина в составе консервативной терапии БГ.

Методы

Методы. В исследование были включены 28 пациенток в возрасте от 19 до 52 лет с впервые выявленной БГ легкого или среднетяжелого течения, которым планировалось проведение тиреостатической терапии в течение 12 мес. Пациентки были рандомизированы в две группы терапии: 1) тиреостатическая терапия + Se (200 мкг); 2) тиреостатическая терапия. Исходно и каждые 3 мес наблюдения оценивались показатели: ТТГ, св.Т4, св.Т3, АТ-ТПО и АТ-рТТГ, также проводилось УЗИ щитовидной железы (ЩЖ), оценивались объем и эхогенностьпаренхимы ЩЖ. Период наблюдения составил 18 мес (12 мес терапии, 6 мес наблюдения после отмены тиреостатической терапии, Se отменялся после 15 мес наблюдения).

Результаты

Результаты. В нашем исследовании не получено статистически значимых отличий между группами терапии БГ по скорости достижения эутиреоза, динамике показателей АТ-рТТГ и АТ-ТПО в течение всего периода наблюдения, частоте развития рецидива заболевания в течение 6 мес после отмены терапии.

Выводы

Выводы. Согласно данным нашего исследования, применение Se в фармакологических дозах (200 мкг в сутки) в рамках комплексной терапии БГ в течение 12 мес не приводило к статистически значимому эффекту в отношении клинических исходов БГ, а также не сопровождалось положительным “аутоиммунным” эффектом.

In spite of previous conflicting results, an adjuvant role of selenium in the treatment of Graves’ disease (GD) hyperthyroidism has been proposed.

The aim of our study was to assess the effects of selenmethionine added to antithyroid drug therapy in patients with GD.

Methods

Methods. Twenty eight newly diagnosed hyperthyroid GD (mild or moderate severity) patients were randomly assigned to treatment during 12 months with: 1) thiomazole and levothyroxine + selenium or 2) thiomazole and levothyroxine. At base line and every 3 months the levels of TSH, fT4, fT3, TPO Ab, TRAbwere measured. For the thyroid tissue echogenicity assessment thyroid ultrasound was preformed. Follow-up period lasted 18 months (12 months of anthithyroid therapy, 6 month after withdrawal of antithyroid therapy, selenium was withdrawn after 15 months of therapy).

Results

Results. There were no significant difference between the groups in biochemical restoration of hyperthyroidism, titers of TPO Ab and TRAb during the whole observational period. There were also no difference between the treatment groups in rate of relapse after the withdrawal of treatment.

Conclusions

Conclusions. Our study, failed to show an adjuvant role of selenium in the control of hyperthyroidism in patients with newly diagnosed GD.

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The authors declare that there are no conflicts of interest present.