免疫抑制剂联合抗甲状腺药物对Graves病患者的临床疗效及血清炎症因子的影响  

Influence on the clinical efficacy and serum inflammatory factors of immunosuppressive agents combined with anti thyroid drugs on patients with Graves disease

作　　者：符兰芳[1] 蒙绪标[1] 熊青[1] 陈玲[1] 

机构地区：[1]海南省海口市人民医院内分泌科,海南海口570208

出　　处：《中国医药导报》2015年第34期122-125,共4页China Medical Herald

基　　金：海南省自然科学基金立项项目(811152)

摘　　要：目的观察免疫抑制剂联合抗甲状腺药物对Graves病患者的临床疗效及血清炎症因子的影响。方法将海口市人民医院2012年6月~2014年6月收治的76例Graves病患者作为研究对象,并将其随机分为实验组和对照组,每组38例。实验组患者给予甲巯咪唑20 mg/d+醋酸泼尼松10 mg/d+雷公藤多苷片10 mg/d治疗,对照组患者给予甲巯咪唑20 mg/d进行治疗。比较两组治疗6个月后的临床疗效、治疗前后的甲状腺体积以及相关细胞因子。结果治疗6个月后实验组总有效率(84.2%)显著高于对照组(63.2%),差异有统计学意义(P<0.05)。实验组治疗3、6个月后的甲状腺体积[(21.3±6.8)、(7.3±3.4)cm^3]显著低于对照组[(28.6±5.2)、(17.3±6.1)cm^3](P<0.05)。治疗6个月后实验组促甲状腺激素[(0.34±0.21)μU/mL]、血清游离三碘甲腺原氨酸[(4.5±1.6)pg/mL]、白介素-6[(4.3±1.6)ng/L]以及肿瘤坏死因子α[(11.4±4.6)ng/L]水平均显著优于对照组[(0.12±0.07)μU/mL、(7.4±3.2)pg/mL、(5.4±2.7)ng/L、(12.8±5.2)ng/L](P<0.05)。结论免疫抑制剂联合抗甲状腺药物在治疗Graves病方面临床效果显著,同时能够有效地调节血清细胞因子水平,值得临床进一步推广。Objective To observe the influence of immunosuppressive agents combined with anti thyroid drugs on the clinical efficacy and serum inflammatory factors of patients with Graves disease. Methods Seventy six cases of patients with Graves disease admitted to Haikou People＇s Hospital from June 2012 to June 2014 were selected as research objects, and they were randomly divided into the experimental group and the control group, with 38 cases in each group.The patients in experimental group were treated by Methimazole 20 mg/d ＋ Prednisone Acetate 10 mg/d ＋ Tripterygium Glycosides Tablets 10 mg/d. The control group was treated by Methimazole 20 mg/d. The clinical curative effect after treatment for 6 months, the thyroid volume and related cytokines before and after treatment in the two groups were compared. Results After treatment for 6 months, the total effective rate of experimental group（84.2%） was higher than that of control group（63.2%）, the difference was statistically significant（P〈0.05）. The thyroid volume after treatment for 1 month and 3 months in the experimental group [（21.3±6.8）,（7.3±3.4） cm^3] were significantly lower than those of control group [（28.6±5.2）,（17.3±6.1） cm^3]（P〈0.05）. After treatment for 6 months, the levels of thyroid-stimulating hormone [（0.34±0.21） μU/mL], free triiodothyronine [（4.5 ±1.6） pg/mL], interleukin-6 [（4.3 ±1.6） ng/L] and tumor necrosis factor-alpha [（11.4±4.6） ng/L] in the experimental group were all better than those of control group [（0.12±0.07） μU/mL,（7.4±3.2） pg/mL,（5.4±2.7） ng/L,（12.8±5.2） ng/L]（P〈0.05）. Conclusion Immunosuppressive agents combined with anti thyroid drugs in patients with Graves disease has a remarkable clinical curative effect, at the same time, it can adjust the serum inflammatory factors effectively, which is worthy of clinical further promotion.

关 键 词：免疫抑制剂 抗甲状腺药物 GRAVES病 炎症因子 

分 类 号：R581.11[医药卫生—内分泌]