甲巯咪唑联合比索洛尔治疗甲状腺功能亢进性心肌病的效果及其对血管内皮功能的影响  

Effect of Methimazole Combined with Bisoprolol in the Treatment of Hyperthyroid Cardiomyopathy and Its Influence on Vascular Endothelial Function

作　　者：陈耿钦 薛银华 CHEN Gengqin;XUE Yinhua(Kangmei Hospital,Puning 515300,China;不详)

机构地区：[1]康美医院,广东普宁515300

出　　处：《中外医学研究》2022年第4期12-16,共5页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探讨甲巯咪唑联合比索洛尔治疗甲状腺功能亢进性心肌病(甲亢性心肌病)的效果及其对血管内皮功能的影响。方法:选取2019年1月-2020年10月在康美医院确诊的88例甲亢性心肌病患者。按照随机数字表法将患者分为观察组和对照组,各44例。两组均接受一般治疗,同时均进行甲巯咪唑片治疗,在此基础上,对照组进行普萘洛尔片治疗,观察组进行比索洛尔片治疗。对比两组临床疗效,治疗前后心肌酶指标[α-羟丁酸脱氢酶(α-HBD)、乳酸脱氢酶(LDH)、谷草转氨酶(AST)、磷酸肌酸激酶(CK)和磷酸肌酸激酶同工酶(CK-MB)]、甲状腺激素水平[血清游离三碘甲状腺原氨酸(FT_(3))、游离甲状腺素(FT_(4))和促甲状腺激素(TSH)]、血管内皮功能[血管内皮依赖性舒张功能(EDD)、血管内皮非依赖性舒张功能(NEDD)]、左室质量指数(LVMI)及不良反应。结果:观察组总显效率(90.91%)明显高于对照组(68.18%)(P<0.05);治疗后,两组α-HBD、CK-MB、CK、LDH、AST、LVMI、FT_(3)、FT_(4)水平均降低,EDD、NEDD、TSH水平均升高,且观察组α-HBD、CK-MB、CK、LDH、AST、LVMI、FT_(3)、FT_(4)水平均低于对照组,EDD、NEDD、TSH水平均高于对照组(P<0.05)。两组治疗期间不良反应发生率比较差异无统计学意义(P>0.05)。结论:甲巯咪唑联合比索洛尔治疗甲亢性心肌病可有效降低心肌酶水平,减少心肌损伤,改善患者血管内皮功能,进而促进心血管功能恢复,缓解心肌病变症状和甲亢的病情进展。Objective:To investigate the effect of Methimazole combined with Bisoprolol in the treatment of hyperthyroid cardiomyopathy and its influence on vascular endothelial function.Method:A total of 88 patients with hyperthyroid cardiomyopathy diagnosed in Kangmei Hospital from January 2019 to October 2020 were selected.According to the random number table method,the patients were divided into the observation group and the control group,44 cases in each group.Both groups received general treatment and Methimazole Tablets.On the basis,the control group received Propranolol Tablets treatment,the observation group received Bisoprolol Tablets treatment.The clinical efficacy,myocardial enzyme indexes[α-hydroxybutyrate dehydrogenase(α-HBD),lactate dehydrogenase(LDH),aspartate aminotransferase(AST),creatine phosphokinase(CK)and creatine kinase isoenzyme-MB(CK-MB)],thyroid hormone levels[serum free triiodothyrosine(FT_(3)),free thyroxine(FT_(4))and thyroid stimulating hormone(TSH)],vascular endothelial function[vascular endothelium-dependent diastolic function(EDD),vascular endothelial independent relaxation function(NEDD)],left ventricular mass index(LVMI)before and after treatment and adverse reactions of the two groups were compared.Result:The total significant efficiency of observation group(90.91%)was significantly higher than that of control group(68.18%)(P<0.05).After treatment,the levels ofα-HBD,CK-MB,CK,LDH,AST,LVMI,FT_(3) and FT_(4) in both groups decreased,and the levels of EDD,NEDD and TSH increased,and the levels ofα-HBD,CK-MB,CK,LDH,AST,LVMI,FT_(3) and FT_(4) in the observation group were lower than those in the control group,the levels of EDD,NEDD and TSH in the observation group were higher than those of control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups during treatment(P>0.05).Conclusion:Methimazole combined with Bisoprolol in the treatment of hyperthyroid cardiomyopathy can effectively reduce the level of myocardial enzymes,reduce myocar

关 键 词：甲巯咪唑 比索洛尔 普萘洛尔 甲亢性心肌病 血管内皮功能 

分 类 号：R541.85[医药卫生—心血管疾病]