目的 系統(tǒng)評(píng)價(jià)硒補(bǔ)充劑聯(lián)合抗甲狀腺藥物治療對(duì)Graves病患者的療效。方法 全面檢索Pubmed、Medline、Cochrane Library、Embase、Web of Science、中國學(xué)術(shù)期刊全文數(shù)據(jù)庫（CNKI）、中國生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫（CBM）及萬方數(shù)據(jù)庫，檢索時(shí)間自建庫至2018年6月，根據(jù)納入排除標(biāo)準(zhǔn)篩選符合的隨機(jī)對(duì)照試驗(yàn)（RCT），通過RevMan 5.0及Stata12.0軟件進(jìn)行分析。結(jié)果 共納入9篇RCT，Meta-分析結(jié)果顯示：聯(lián)用硒補(bǔ)充劑治療組Graves病患者與對(duì)照組相比游離三碘甲狀腺原氨酸（FT3）、游離甲狀腺素（FT4）水平均顯著降低[WMD=-1.48，95% CI （-1.93，-1.02）及WMD=-4.89，95% CI （-7.22，-2.56）]，血清促甲狀腺素（TSH）水平顯著升高[WMD=0.57，95% CI （0.29，0.86）]；甲狀腺過氧化物酶抗體（TPOAb）、甲狀腺球蛋白抗體（TGAb）、促甲狀腺激素受體抗體（TRAb）及免疫球蛋白IgA、IgG水平均顯著降低，而免疫球蛋白IgM水平兩組間差異無統(tǒng)計(jì)學(xué)意義。結(jié)論 應(yīng)用抗甲狀腺藥物聯(lián)合硒補(bǔ)充治療可顯著改善Graves病患者甲狀腺功能水平，顯著降低FT3及FT4水平，升高TSH水平，改善自身抗體水平，顯著降低TPOAb、TGAb、TRAb、IgA及IgG水平。

Objective To evaluate the efficacy of selenium combined with antithyroid drugs in patients with Graves'disease.Methods Randomized randomized controlled trials (RCTs) from Pubmed,Medline,Cochrane Library,Embase,Web Of Science,CNKI,CBM and Wanfang database were searched from inception up to June 2018,the RCTs were screenedaccording to the inclusion and exclusion criteria.RevMan 5.0 software and Stata 12.0 software was used to process data analysis.Results A total of 9 RCTs were included.The result of meta-analysis showed that the levels of serum FT3 and FT4 in selenium supplemental treatment group were significantly decreased than the control group[WMD=-1.48,95% CI (-1.93,-1.02);WMD=-4.89,95% CI (-7.22,-2.56),respectively],while TSH was significantly increased than the control group[WMD=0.57,95% CI (0.29,0.86)].The levels of thyroid peroxidase antibodys as TPOAb,TGAb,TRAb and immunoglobulin IgA,IgG in selenium supplemental treatment group were significantly lower than the control group,while no significant difference was showed between the two groups in the level of IgM.Conclusion The results of Meta-analysis shows that selenium combined with antithyroid drugs in supplemental treatment of Graves'disease can significantly improve the thyroid function.The levels of FT3 and FT4 were significantly decrease and the level of TSH was increased.Besides,selenium combined with antithyroid drugs can significantly improve the levels of autoantibodies.The levels of TPOAb,TGAb,TRAb,IgA and IgG were significantly decreased.

國家自然科學(xué)基金資助項(xiàng)目（81703427）；中國醫(yī)科大學(xué)附屬第一醫(yī)院院內(nèi)基金資助項(xiàng)目（FSFH201718）