甲巯咪唑治疗甲状腺功能亢进症的临床问题探讨  

Clinical discussion on methimazole in the treatment of hyperthyroidism

作　　者：茅江峰 伍学焱 Mao Jiangfeng;Wu Xueyan(Chinese Academy of Medical Sciences,Peking Union Medical College,Department of Endocrinology,Peking Union Medical College Hospital,NHC Key Laboratory of Endocrinology,Beijing,100730,China)

机构地区：[1]中国医学科学院,北京协和医学院,北京协和医院内分泌科,国家卫生健康委员会内分泌重点实验室,北京100730

出　　处：《中华医学杂志》2023年第5期311-314,共4页National Medical Journal of China

基　　金：国家自然科学基金(81771576、81971375);北京自然科学基金(7212080)

摘　　要：甲巯咪唑是治疗甲状腺功能亢进症(甲亢)最常用的药物,其效果良好,不良反应少。初始剂量选择不当将影响疗效,如剂量过大易发生各种不良反应;剂量过小,达不到预期疗效。本文笔者根据文献及个人临床经验,对甲巯咪唑治疗甲亢的以下临床问题进行探讨,包括甲巯咪唑的起始剂量选择、剂量调整和停药、伴肝功能损伤者药物治疗及甲巯咪唑相关不良反应的应对策略等。Methimazole is the most commonly used medication for hyperthyroidism with good effects and little adverse reactions.However,improper selection of initial dose will affect the efficacy,such as excessive dose is proven to various adverse reactions;insufficient dose can hardly achieve desired efficacy.Based on the literature and personal clinical experience,the author discusses the following clinical issues related to methimazole in the treatment of hyperthyroidism,including the selection of initial dose,dose adjustment and withdrawal of methimazole,drug therapy for patients with liver function injury,and management strategies for methimazole-related adverse reactions.

关 键 词：甲状腺功能亢进症 甲巯咪唑 肝功能异常 中性粒细胞缺乏症 不良反应 

分 类 号：R581.1[医药卫生—内分泌]