普萘洛尔联合甲巯咪唑治疗甲状腺功能亢进疗效及对骨代谢的影响  

Clinical Effect of Propranolol Combined with Methimazole in Treating Hyperthyroidism and Its Effect on Bone Metabolism

作　　者：李剑[1] 张秀媛 袁戈恒[3] 闫双通[1] 卢彦慧 成小玲[1] 邵迎红[1] Li Jian;Zhang Xiuyuan;Yuan Geheng;Yah Shuangtong;Lu Yanhu;Cheng Xiaoling;Shao Yinghong(Chinese PLA General Hospital, Beijing, China 100853;Shunyi Hospital of Beijing Chinese MediciTw Hospital, Beijing, China 101300;Peking University First Hospital, Beijing, China 100034)

机构地区：[1]中国人民解放军总医院,北京100853 [2]北京中医医院顺义医院,北京101300 [3]北京大学第一医院,北京100034

出　　处：《中国药业》2018年第11期64-66,共3页China Pharmaceuticals

摘　　要：目的探讨普萘洛尔联合甲巯咪唑治疗甲状腺功能亢进(简称甲亢)疗效和对骨代谢的影响。方法选取中国人民解放军总医院2016年5月至2017年5月收治的甲亢患者120例,按信封法随机分为联合组和对照组,各60例。两组患者均采用甲巯咪唑治疗,起始剂量为每次20 mg,每日1次,症状改善后为每次10 mg,每日1次,持续治疗3个月;联合组加用普萘洛尔,每次10 mg,每日3次,持续治疗3个月。结果与对照组比较,联合组治疗有效率(96.67%比83.33%)升高;与治疗前比较,两组治疗1,3个月的血清甲状旁腺激素(PTH)水平升高,同期的血清降钙素(CT)、骨钙素(BGP)水平则降低(P<0.05),且联合组上述指标变化更显著(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论普萘洛尔联合甲巯咪唑治疗甲亢可提高患者PTH水平,降低CT和BGP水平,可行性和安全性良好,值得推广。Objective To investigate the clinical effect of propranolol combined with methimazole for treating hyperthyroidism and its effect on bone metabolism. Methods Totally 120 patients with hyperthyroidism admitted to Chinese PLA General Hospital from May 2016 to May 2017 were selected and randomly divided into the combined group and the control group by the envelope method,60 cases in each group. The two groups were treated with methimazole with starting dose 20 mg/time,1 time/d, and 10 mg/time after the symptoms improvement, 1 time/d, and continuously treated for 3 months. In additional, the combined group was treated with propranolol,10 mg/time,3 times/d,and continuously treated for 3 months. Results Compared with the control group,the effective rate of the combined group was higher（ 96. 67% vs. 83. 33%, P〈0. 05）. Compared with before treatment, the levels of serum PTH in the two groups were increased after treated for 1 month and 3 months, while the levels of serum CT and BGP in the two groups were decreased in the same period（ P〈0. 05）, and the improvement in the combined group was more significant（ P〈0. 05）. There were no significant differences in the incidence rates of adverse reactions in the two groups（ P〈0. 05）. Conclusion Propranolol combined with methimazole for treating hyperthyroidism can increase the level of PTH,decrease the levels of CT and BGP,it has good feasibility and safety,which is worthy of promotion.

关 键 词：普萘洛尔 甲巯咪唑 甲状腺功能亢进 甲状旁腺激素 骨代谢指标 

分 类 号：R969.4[医药卫生—药理学]