摘要
目的比较甲巯咪唑与丙硫氧嘧啶治疗毒性播散性甲状腺肿(Graves病)甲状腺功能亢进症(甲亢)患者的临床疗效。方法 110例Graves病甲亢患者,随机分为A组和B组,每组55例。A组采用甲巯咪唑治疗,B组采用丙硫氧嘧啶治疗。比较治疗前后游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺素(TSH)、甲状腺过氧化物酶抗体(TPOAb)以及促甲状腺素受体抗体(TRAb)的水平以及治疗期间的不良反应发生情况。结果 A组患者治疗前FT3为(9.48±2.05)pmol/L、FT4为(18.34±4.09)pmol/L、TSH为(5.46±1.54)μIU/ml、TPOAb为(57.03±12.41)IU/ml、TRAb为(16.32±3.23)U/L;B组上述指标分别为(9.42±2.12)pmol/L、(18.39±4.13)pmol/L、(5.49±1.66)μIU/ml、(56.94±11.36)IU/ml、(16.42±4.57)U/L;治疗后,A组患者FT3为(3.12±0.69)pmol/L、FT4为(9.15±2.52)pmol/L、TSH为(1.49±0.51)μIU/ml、TPOAb为(21.99±5.62)IU/ml、TRAb为(3.76±0.72)U/L;B组上述指标分别为(5.44±1.18)pmol/L、(13.05±3.58)pmol/L、(2.81±0.73)μIU/ml、(22.13±7.51)IU/ml、(3.92±0.86)U/L。治疗后两组患者FT3、FT4、TSH、TPOAb及TRAb水平均明显低于治疗前(P<0.05);A组FT4、FT3的水平明显高于B组(P<0.05);两组患者TPOAb、TRAb水平比较差异无统计学意义(P>0.05)。两组患者不良反应发生率比较差异无统计学意义(P>0.05)。结论与丙硫氧嘧啶比较,甲巯咪唑治疗Graves病甲亢患者的临床疗效更加显著,患者机体激素水平得到显著的改善,安全性较高,值得临床大力的推广。
Objective To compare clinical effects by methimazole and propylthiouracil in the treatment of Graves＇ hyperthyroidism patients. Methods A total of 110 patients with Graves＇ hyperthyroidism were randomly divided into group A and group B, with 55 cases in each group. Group A received methimazole for treatment, and group B received propylthiouracil for treatment. Comparison was made on free triiodothyronine（FT3）, free thyroxine（FT4）, thyroid stimulating hormone（TSH）, thyroid peroxidase antibody（TPOAb）, thyrotrophin receptor antibody（TRAb） levels before and after treatment and adverse reactions during treatment between the two groups. Results Group A had FT3 as（9.48±2.05） pmol/L, FT4（18.34±4.09） pmol/L, TSH as（5.46±1.54） μIU/ml, TPOAb as（57.03±12.41） IU/ml, and TRAb as（16.32±3.23） U/L before treatment, which were respectively（9.42±2.12） pmol/L,（18.39±4.13） pmol/L,（5.49±1.66） μIU/ml,（56.94±11.36） IU/ml and（16.42±4.57） U/L in group B. After treatment, group A had FT3 as（3.12±0.69） pmol/L, FT4（9.15±2.52） pmol/L, TSH as（1.49± 0.51） μIU/ml, TPOAb as（21.99±5.62） IU/ml, and TRAb as（3.76±0.72） U/L, which were respectively（5.44±1.18） pmol/L,（13.05±3.58） pmol/L,（2.81±0.73） μIU/ml,（22.13±7.51） IU/ml and（3.92±0.86） U/L in group B. Both groups had obviously lower FT3, FT4, TSH, TPOAb and TRAb levels after treatment than those before treatment（P〈0.05）. Group A had much higher FT3 and FT4 levels than group B（P〈0.05）, while there was no statisticsally significant difference of TPOAb and TRAb levels between the two groups（P〉0.05）. The difference of incidence of adverse reactions had no statistical significance between the two groups（P〉0.05）. Conclusion Comparing with propylthiouracil, methimazole shows much remarkable clinical effect in treating Graves＇ hyperthyroidism patients. It obviously improve hormone level in patients with high safety, and it is worth widely clinical promotio
作者
朱秀莲
ZHU Xiu-lian. Weifang(City People＇s Hospital, Weifang 261000, China)
出处
《中国实用医药》
2017年第6期9-11,共3页
China Practical Medicine
