左甲状腺素钠分两次给药对原发性甲减患者甲状腺功能及耐受性的影响研究  

Effect of Levothyroxine Bid on the thyroid hormone levels and tolerance in patients with primary hypothyroidism

作　　者：赖珺[1] 张四青[2] 廖晓飞[1] 

机构地区：[1]江西省赣州市人民医院药剂科,江西赣州341000 [2]江西省赣州市人民医院内分泌科,江西赣州341000

出　　处：《中国当代医药》2017年第26期42-44,共3页China Modern Medicine

基　　金：江西省赣州市指导性科技计划项目(GZ2016ZSF163)

摘　　要：目的探讨左甲状腺素钠Bid替代Qd的服药方式对原发性甲状腺功能减退患者甲状腺激素水平及耐受性的影响。方法选取2015年8月~2016年8月我院收治的40例原发性甲减患者作为研究对象,按1:1随机分为A、B两组,均进行为期24周的两阶段随机交叉对照试验,第一阶段为前12周,A组Qd服药,B组Bid服药,第二阶段为后12周,两组转换给药方式。观察各阶段结束时患者的甲状腺激素水平和心率的变化。结果 40例患者均完成试验,比较两组患者各甲状腺激素水平,TSH水平的增幅处理效应为-0.03,FT3水平为0.15,FT4水平为0.35,差异均无统计学意义(P>0.05)。两组患者的心率水平比较,心率的增幅处理效应为3.32,差异有统计学意义(P<0.01)。结论与左甲状腺素钠Qd给药方案比较,Bid给药能使患者甲状腺激素水平在正常范围内,可提高甲减患者对甲状腺激素的耐受性,是一种安全且有效的治疗选择。Objective To investigate the effect of Levothyroxine Bid instead of Qd on the thyroid hormone levels and tolerance in patients with primary hypothyroidism.Methods The 40 patients with primary hypothyroidism who were admitted to our hospital from August 2015 to August 2016 were selected as the subjects,they were randomly and equally divided into group A and group B.The two groups of patients underwent two-phase randomized cross-control trials for 24 weeks.The first stage for the first 12 weeks,the administration method of group A was Qd,the administration method of group B was Bid.The second stage was 12 weeks later,and the two groups were converted the administration method.The changes in thyroid hormone levels and heart rate were observed at the end of each phase.Results 40 patients all completed the test,the levels of thyroid hormones were compared between the two groups,the treatment effect increase of TSH level was-0.03,FT3 level was 0.15,FT4 level was 0.35,the differences were not statistically significant（P〈0.05）.The heart rate of the two groups were compared,the treatment effect increase of heart rate was 3.32,and the difference was statistically significant（P〈0.01）.Conclusion Compared with Levothyroxine administration method of Qd,the administration method of Bid can cause Thyroid Hormone levels of the patient to be in normal range,and can improve tolerance of thyroid hormone in the patients with primary hypothyroidism,it is a kind of safe and effective treatment option.

关 键 词：左甲状腺素钠 原发性甲状腺功能减退 甲状腺功能 耐受性 

分 类 号：R581.2[医药卫生—内分泌]