甲巯咪唑与丙基硫氧嘧啶对甲亢继发骨质疏松患者骨密度的影响  

Effect of methimazole and propylthiouracil on bone density of hyperthyroidism patients with secondary osteoporosis

作　　者：项旻[1,2] 曾伟伟[1,2] 叶成夫[1,2] 黄贤恩[1,2] 

机构地区：[1]温州医科大学附属第三医院 [2]瑞安市人民医院内分泌科,温州325200

出　　处：《实用药物与临床》2014年第11期1431-1434,共4页Practical Pharmacy and Clinical Remedies

摘　　要：目的观察甲巯咪唑与丙基硫氧嘧啶对甲亢继发骨质疏松患者骨密度的影响,为临床甲亢继发骨质疏松的治疗提供参考。方法选取2012年12月至2013年12月来我科住院治疗的46例甲亢继发骨质疏松患者,采用随机数字法平均分为观察组和对照组。在常规治疗基础上,观察组采用甲巯咪唑进行治疗,对照组使用丙基硫氧嘧啶进行治疗。比较两组治疗前后的血钙(Ca)、血镁(Mg)、血磷(P)、血碱性磷酸酶(ALP)、24 h尿钙(UCa)变化;于治疗前后测量患者腰椎、股骨颈骨密度(BMD),分析甲巯咪唑与丙基硫氧嘧啶对甲亢继发骨质疏松患者骨密度的影响;并比较两组药物不良反应的发生情况。结果观察组治疗后24 h UCa水平明显低于对照组,差异有统计学意义(P<0.05);观察组治疗后Mg水平明显高于对照组,差异有统计学意义(P<0.05)。观察组治疗后Ca、P、ALP水平与对照组比较差异无统计学意义(P>0.05)。观察组治疗后腰椎、股骨颈骨密度均略高于对照组,但差异无统计学意义(P>0.05)。对照组肝功能损害的发生率明显高于观察组,差异有统计学意义(P<0.05)。结论甲巯咪唑和丙基硫氧嘧啶均可以改善甲亢继发骨质疏松患者的骨代谢状态,但甲巯咪唑升高患者骨密度的作用更明显,且不良反应相对较轻,值得临床借鉴使用。Objective To observe the effect of methimazole and propylthiouracil on bone density of hyperthy-roidism patients with secondary osteoporosis,and to provide a reference for the treatment of hyperthyroidism with sec-ondary osteoporosis. Methods 46 cases of hyperthyroidism patients with secondary osteoporosis treated in our hospital from December 2012 to December 2013 were selected and divided into observation group and control group by random number method. Both groups received routine therapy,observation group received methimazole treatment,control group received propylthiouracil treatment. The serum calcium（Ca）,serum magnesium（Mg）,phosphorus（P）,serum alkaline phosphatase（ALP）,24 h urinary calcium（UCa）changes of the two groups before and after treatment were observed and compared. X-ray absorptiometry was used to measure the BMD of lumbar spine,femoral neck,distal radius of the patients before and after treatment. The influence of methimazole and propylthiouracil on the patients was analyzed,and the incidence of adverse drug reactions between the two groups was compared. Results After treatment,24 h UCa of observation group was significantly lower than that of control group （P〈0. 05）;the Mg level was significantly higher than that of control group（P〈0. 05）;there was no significant difference in Ca,P,ALP after treatment between the two groups（P〉0. 05）. No significant difference was observed in lumbar spine,femoral neck,distal radius BMD between the two groups（P〉0. 05）. Control group was significantly higher than observation group in the incidence of liver dys-function（P〈0. 05）. Conclusion Methimazole and propylthiouracil can improve bone metabolism in hyperthyroidism patients with secondary osteoporosis, but the effect of increasing bone mineral density of methimazole is more pro-nounced,and the adverse reactions of methimazole are relatively mild,it is worthy of clinical use.

关 键 词：甲状腺功能亢进 骨质疏松 甲巯咪唑 丙基硫氧嘧啶 

分 类 号：R580[医药卫生—内分泌] R581.1[医药卫生—内科学]