甲巯咪唑联合左甲状腺素治疗小儿甲状腺功能亢进症的效果和安全性  

Clinical effect and safety of methimazole combined with levothyroxine on children with hyperthyroidism

作　　者：黄占克[1] 李维丽[1] Huang Zhanke;Li Weili(Department of Paediatrics,Luohe Third People’s Hospital,Luohe 462000,China)

机构地区：[1]河南省漯河市第三人民医院儿科,462000

出　　处：《中国实用医刊》2021年第19期91-94,共4页Chinese Journal of Practical Medicine

摘　　要：目的分析甲巯咪唑联合左甲状腺素治疗小儿甲状腺功能亢进症(甲亢)的临床效果和安全性。方法抽取2018年1月至2020年7月漯河市第三人民医院收治的甲亢患儿62例,按随机数字表法分为联合组和单一组,每组31例。单一组采用甲巯咪唑,联合组在单一组基础上加用左甲状腺素。比较两组疗效、甲状腺激素[促甲状腺激素(TSH)、游离三碘甲状腺原氨酸(FT3)、游离四碘甲状腺素(FT4)]、甲状腺抗体[甲状腺过氧化物酶抗体(TPOAb)、促甲状腺激素受体抗体(TR-Ab)]、皮质醇(COR)、促肾上腺皮质激素(ACTH)和不良反应发生率。结果联合组总有效率(96.77%,30/31)高于单一组(74.19%,23/31),P<0.05。治疗后,联合组TSH高于单一组,FT3、FT4低于单一组(P<0.05)。治疗后,联合组TPOAb、TR-Ab水平低于单一组(P<0.05)。治疗后,联合组ACTH低于单一组,COR高于单一组(P<0.05)。联合组不良反应发生率(3.23%,1/31)与单一组(12.90%,4/31)比较差异未见统计学意义(P>0.05)。结论甲巯咪唑联合左甲状腺素治疗甲亢患儿,能调节血清因子表达,改善甲状腺功能,提高疗效,且未增加不良反应发生率。Objective To analyze the clinical effect and safety of methimazole combined with levothyroxine on children with hyperthyroidism.Methods A total of 62 children with hyperthyroidism treated in Luohe Third People’s Hospital from January 2018 to July 2020 were selected and divided into combined group and single group by random number table method,with 31 cases in each group.The single group was given methimazole,and the combined group was given levothyroxine based on the treatment of single group.The curative effect,thyroid hormone including thyroid stimulating hormone(TSH),free triiodothyronine(FT3),free tetraiodothyronine(FT4),thyroid antibody,for example thyroid peroxidase antibody(TPOAb)and thyroid stimulating hormone receptor antibody(TR-Ab),cortisol(COR),adrenocorticotropic hormone(ACTH),and incidence of adverse reactions were compared between the two groups.Results The total effective rate of the combined group was 96.77%(30/31),higher than 74.19%(23/31)of single group(P<0.05).After treatment,TSH of combined group was higher than that of single group,while levels of FT3 and FT4 of combined group were lower than those of single group(P<0.05).After treatment,levels of TPOAb and TR-Ab in combined group were lower than those in single group(P<0.05).After treatment,ACTH in combination group was lower than that in single group,and COR was higher than that in single group(P<0.05).There was no significant difference in the incidence of adverse reactions between combined group(3.23%,1/31)and single group(12.90%,4/31),P>0.05.Conclusions Methimazole combined with levothyroxine for children with hyperthyroidism,can regulate the expression of serum factors,improve thyroid function,improve the curative effect,without increasing in the incidence of adverse reactions.

关 键 词：甲状腺功能亢进症 甲巯咪唑 左甲状腺素 甲状腺功能 安全性 

分 类 号：R725.8[医药卫生—儿科]