长疗程使用甲巯咪唑治疗Graves病临床研究  

The Clinical Research of Long-term Treatment with MMI in Patients with Graves Disease

作　　者：李敏[1] 雷永富[1] 

机构地区：[1]江汉油田总医院(五七)内科,湖北省潜江市433121

出　　处：《临床合理用药杂志》2011年第04X期83-85,共3页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的了解长疗程甲巯咪唑片(MMI)治疗Graves病的疗效及不良反应。方法选择155例Graves病甲亢患者为研究对象,全部病例均完成18个月MMI治疗后根据患者意愿分为2组,愿意接受长疗程MMI治疗者为长疗程治疗组,以维持量MMI长疗程治疗,维持甲状腺功能正常;不愿意接受MMI长疗程治疗者,完成18个月疗程后停用MMI,若甲亢复发重新治疗者为常规治疗组。所有患者均使用MMI治疗,最初剂量均为10mg,3次/d,依病情逐渐减量达维持量后,每3～6个月复诊一次,复查甲状腺功能,记录临床表现。结果长疗程治疗组患者的甲状腺肿、突眼、甲状腺过氧化物酶抗体(TPOAb)、三酰甘油(TG)及总胆固醇(TC)、E/A及LVEF均优于常规治疗组;而且心房纤颤、永久性甲减及甲亢复发的发生率均较低,治疗中未见明显不良反应。结论 Graves病甲亢患者接受MMI长疗程治疗有利于维持甲状腺功能正常、甲状腺肿大及突眼的好转,而且其心功能异常、心房纤颤等心血管事件的发生率较低,无明显不良反应。Objective To study the therapeutic effect and it＇s adverse reaction in the course of long-term treatment with MMI.Methods We studied 155 patients with Graves disease hyperthyroidism.all case was divided into two groups according to patient＇s demand after they finished a total of treatment course with MMI for 18 months,the long-term treatment group,they would been treated by long-term usage MMI to maintain thyroid function normal;Conventional treatment group,they would not requested to accept long-term treatment with MMI and the treatment would been stop after treated the distance for 18 months,if hyperthyroidism relapsed they would been treated again.The beginning dose of MMI was 30 mg /d in all patients treated by MMI（10mg,tid）.the usage MMI dose were reduced gradually to reach maintenance dose according to their thyroid state,they were followed up once three to six months,thyroid function were reexamination and their clinic performances were recorded.Results Goiter,prominent eyes,TPOAb,TG,TC,E/A and LVEF in long course of treatment group patients were superior routine treatment group;the incidence of atrium fibrillation,permanent hypothyroid and hyperthyroid relapse were lower in long-term treatment group.Obvious adverse reaction was not found in the course of treatment.Conclusion The patients treated by Long-term MMI were advantageous to maintain normal thyroid function,goiter and exorbitism.their the incidence of cardiovascular events（heart dysfunction and atrium fibrillation） were lower,obvious adverse reaction were not detected.

关 键 词：甲巯咪唑 长疗程治疗 GRAVES病 

分 类 号：R581.1[医药卫生—内分泌]