不同时间口服左旋甲状腺素治疗甲状腺功能减退的疗效与安全性评价  

Evaluation of the efficacy and safety of oral levothyroxine at different times in the treatment of hypothyroidism

作　　者：陈说[1] 张帆[1] 彭卫群[1] 吴佩娴[1] 林远[1] 

机构地区：[1]北京大学深圳医院内分泌科,518036

出　　处：《中国现代药物应用》2018年第4期71-73,共3页Chinese Journal of Modern Drug Application

摘　　要：目的分析早上空腹口服左旋甲状腺素与睡前口服左旋甲状腺素在甲状腺功能减退症治疗中的疗效以及安全性。方法 86例甲状腺功能减退症患者,随机分成A组和B组,每组43例。A组于早上空腹口服左旋甲状腺素,B组于睡前口服左旋甲状腺素,对比两组治疗效果及药物不良反应。结果治疗前两组患者血清游离三碘甲腺原氨酸(FT3)在正常范围,血清游离甲状腺素(FT4)均低于正常值,两组FT3、FT4水平比较差异无统计学意义(P>0.05);经过3个月治疗,两组FT3和FT4水平均有升高,B组患者FT4升高较A组明显(P<0.05)。治疗前两组患者促甲状腺激素(TSH)均高于正常范围,比较差异无统计学意义(P>0.05);治疗后B组患者的TSH水平明显低于A组(P<0.05)。A组不良反应发生率为11.63%,B组不良反应发生率为16.28%,两组比较差异无统计学意义(P>0.05)。结论睡前服用左旋甲状腺素治疗甲状腺功能减退症患者疗效确切,可以促进药物的有效吸收,保证用药安全性。Objective To analyze the efficacy and safety of oral levothyroxine in the morning and oral levothyroxine before bedtime in the treatment of hypothyroidism. Methods A total of 86 hypothyroidism patients were randomly divided into group A and group B, with 43 cases in each group. Group A received oral levothyroxine in the morning, and group B received oral levothyroxine before bedtime. Comparison were made on treatment effect and adverse drug reactions between the two groups. Results The serum free thyroprosine（FT3） was in the normal range in the two groups before treatment, and the serum free thyroxine（FT4） was lower than the normal value. Both groups had no statistically significant differences in FT3 and FT4 level（P〈0.05）. After 3 months of treatment, both groups had higher FT3 and FT4 level, and group B had obviously higher FT4 than group A（P〈0.05）. The thyroid stimulating hormone（TSH） in the two groups was higher than the normal range before the treatment, but the difference was not statistically significant（P〈0.05）. After treatment, group B had obviously lower TSH level than group A（P〈0.05）. Group A had incidence of adverse reactions as 11.63%, which was 16.28% in group B, but the difference was not statistically significant（P〈0.05）. Conclusion Oral levothyroxine before bedtime shows affirmative efficacy in the treatment of hypothyroidism, and can promote the effective absorption of drugs and ensure drug safety.

关 键 词：左旋甲状腺素 服药时间 甲状腺功能减退症 不良反应 

分 类 号：R581.2[医药卫生—内分泌]