摘要
目的 对左甲状腺素和小剂量甲硫咪唑联合用药治疗Graves甲亢的临床疗效进行探讨。方法 将入组的162例Graves甲亢患者随机分为对照组(小剂量甲硫咪唑治疗,79例)、观察组(甲状腺素+小剂量甲硫咪唑治疗,83例)。对照组在前3个月口服小剂量甲硫咪唑片,剂量控制在10~20mg/d,1次/d,后续根据病情情况逐步减少剂量至维持剂量(2.5~7.5mg/d)。观察组在对照组的治疗基础上服用左甲状腺素片(25μg/d,2次/d)。治疗前后比较2组患者的甲状腺功能指标,对治疗中的不良反应和治疗结束后的复发情况进行比较。结果 在治疗12个月时,与对照组同期相比较,观察组的甲状 腺功能指标游离三碘甲状腺原氨酸(FT3)、促甲状腺素(TSH)、血清游离甲状腺素(FT4)和促甲状腺激素受体抗体(TRAb)均有明显改善(P﹤0.05),有效率有明显提高(P﹤0.05),不良反应发生率未发现有显著性差异(P﹥0.05);治疗后观察组在复发率与对照组相比,有明显降低(P﹤0.05)。结论 在Graves甲亢的药物治疗中,采用左甲状腺素和小剂量甲硫咪唑联合治疗方案,具有临床疗效好、安全性高和复发率低的优点。
Objective To investigate the clinical efficacy of levothyroxine combined with a low dose of methionazole on the treatment of Graves hyperthyroidism.Methods A total of 162 patients with Graves hyperthyroidism were randomly divided into a control group (n =79)and an observation group (n =83).The control group was administrated with a small dose of methimazole (10-20mg/d,once per day)in the first three months,followed by a maintenance dose of 2.5-7.5mg/d according to patient conditions.Based on the control group's treatment,the observation group was given 25μg levothyroxine per day,twice per day.All parients were treated for two years.The two groups were compared for thyroid function indicators before and after treatment,adverse reactions during the treatment process and the recurrence after treatment.Results After 12 months of treatment,compared with the control group,the observation group showed remarkably improved thyroid function indexes (P <0.05)with a significantly increased effective rate (P <0.05).Meanwhile,there was no significant difference in the incidence of adverse reactions between the two groups (P >0.05).After treatment,a markedly decreased recurrence rate was found in the observation group compared with the control group (P <0.05).Conclusions Levothyroxine combined with a low dose of methionazole can treat Graves hyperthyroidism well, with good clinical efficacy,high safety and a low recurrence rate.
作者
范静静
应长江
姚楚晨
李伟
FAN Jingjing;YING Changjiang;YAO Chuchen;LI Wei(Department of Endocrinology,the Affiliated Hospital of Xuzhou Medical University,Xuzhou,Jiangsu 221002,China)
出处
《徐州医科大学学报》
CAS
2018年第11期719-722,共4页
Journal of Xuzhou Medical University
基金
徐州市重点研发计划项目(KCl7194).
