甲巯咪唑和丙硫氧嘧啶治疗弥漫性毒性甲状腺肿合并桥本甲亢的疗效分析  

Efficacy analysis of Methimazole and Propylthiouracil in the treatment of diffuse toxic goiter complicated with Hashimoto hyperthyroidism

作　　者：林汉英[1] LIN Hanying(Department of Endocrinology,the First People′s Hospital of Zhaoqing City,Guangdong Province,Zhaoqing 526000,China)

机构地区：[1]广东省肇庆市第一人民医院内分泌科,广东肇庆526000

出　　处：《中国当代医药》2022年第7期82-85,共4页China Modern Medicine

基　　金：广东省中医药局科研项目(20211451)。

摘　　要：目的探讨甲巯咪唑和丙硫氧嘧啶治疗弥漫性毒性甲状腺肿(Graves病)合并桥本甲亢的疗效及对甲状腺过氧化物酶抗体(TPOAb)、甲状腺球蛋白抗体(TgAb)和促甲状腺素受体抗体(TRAb)指标的影响。方法选取2018年9月至2019年8月肇庆市第一人民医院内分泌门诊就诊的98例Graves病合并桥本甲亢患者作为研究对象,采取随机数字表法分为观察组(49例)和对照组(49例)。观察组应用甲巯咪唑治疗,对照组应用丙硫氧嘧啶治疗,观察两组患者的临床疗效、TPOAb、TgAb和TRAb指标变化及不良反应总发生率。结果治疗后,两组的TPOAb、TgAb、TRAb、游离三碘甲状腺原氨酸(FT_(3))、游离甲状腺激素(FT_(4))水平低于治疗前,高代谢症状减轻比例、促甲状腺激素(TSH)高于本组治疗前,且观察组的TPOAb、TgAb、TRAb、FT_(3)、FT_(4)水平低于对照组,高代谢症状减轻比例、TSH高于同时期对照组,差异有统计学意义(P<0.05)。观察组治疗后的不良反应总发生率低于对照组,差异有统计学意义(P<0.05)。结论针对Graves病合并桥本甲亢的治疗,丙硫氧嘧啶与甲巯咪唑两种药物均可发挥较好的治疗效果,其中甲巯咪唑的治疗效果较丙硫氧嘧啶更好,且用药后不良反应少,安全性高,值得临床广泛推广。Objective To investigate the efficacy of Methimazole and Propylthiouracil in the treatment of diffuse toxic goiter(Graves disease)complicated with Hashimoto hyperthyroidism and their influence on thyroid peroxidase antibody(TPOAb),thyroglobulin antibody(TgAb)and thyrotropin receptor antibody(TRAb).Methods A total of 98 patients with Graves disease complicated with Hashimoto hyperthyroidism treated in the Endocrine Clinic of the First People′s Hospital of Zhaoqing City from September 2018 to August 2019 were selected as the research objects.They were divided into the observation group(49 cases)and the control group(49 cases)according to random number table method.The observation group was treated with Methimazole,and the control group was treated with Propylthiouracil.The clinical efficacy,the changes of TPOAb,TGAb and TRAb indexes and the total incidence of adverse reactions were observed in the two groups.Results After treatment,the levels of TPOAb,TgAb,TRAb,free triiodothyrine(FT_(3)),free thyroid hormone(FT_(4))in the two groups were lower than those before treatment,the proportions of hypermetabolic symptom reduction and thyroid stimulating hormone(TSH)in the two groups were higher than those before treatment,the levels of TPOAb,TgAb,TRAb,FT_(3),FT_(4) in the observation group were lower than those in the control group,the proportions of hypermetabolic symptom reduction and TSH in the observation group was higher than that in the control group,and the differences were statistically significant(P<0.05).The total incidence of adverse reactions after treatment in the observation group was significantly lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion For the treatment of Graves disease complicated with Hashimoto hyperthyroidism,Propylthiouracil and Methimazole can play a better therapeutic effect.Among them,Methimazole has a better therapeutic effect than Propylthiouracil,with less adverse reactions and high safety,which is worthy of wide clinical promoti

关 键 词：GRAVES病 桥本甲亢 甲巯咪唑 丙硫氧嘧啶 甲状腺功能 

分 类 号：R581.3[医药卫生—内分泌]