甲巯咪唑治疗弥漫性毒性甲状腺肿及桥本毒症后甲状腺激素与甲状腺上动脉流速变化的对比分析  

Comparative analysis of the changes of thyroid-stimulating hormone and the flow velocity of superior thyroid artery in the treatment of diffuse toxic goiter and Hashimoto's thyroiditis with methimazole

作　　者：魏剑芬 吴乃君 程明慧 成曦爽 任杰 靳玉倩 焦丽静 阚芳芳 盛佳曦 Wei Jianfen;Wu Naijun;Cheng Minghui;Cheng Xishuang;Ren Jie;Jin Yuqian;Jiao Lijing;Kan Fangfang;Sheng Jiaxi(Department of Endocrinology,North China University of Science and Technology Affiliated Hospital,Tangshan 063000,China;Department of Radiology,Affiliated Hospital of North China University of Science and Technology,Tangshan 063000,China)

机构地区：[1]华北理工大学附属医院内分泌科,唐山063000 [2]华北理工大学附属医院放射科,唐山063000

出　　处：《中国综合临床》2024年第2期108-113,共6页Clinical Medicine of China

基　　金：河北省科技厅科技计划项目(162777135)。

摘　　要：目的探讨弥漫性毒性甲状腺肿(graves disease,Graves病)及桥本毒症患者在甲巯咪唑治疗前后甲状腺激素及甲状腺上动脉流速变化。方法采用病例对照研究,选取在2021年10月至2022年12月华北理工大学附属医院内分泌科就诊的Graves病(Graves病组)、慢性淋巴细胞性甲状腺炎甲状腺功能亢进病例(桥本毒症组)各45例为研究对象。分析Graves病组以及桥本毒症组患者甲状腺激素及甲状腺上动脉血流速度经甲巯咪唑治疗前后变化。满足正态分布的计量资料以x¯±s表示,两组间均数比较采用t检验;不满足正态分布的计量资料以M(Q_(1),Q_(3))表示,两组间中位数比较采用Wilcoxon秩和检验。计数资料组间构成比比较采用χ^(2)检验。结果治疗前两组间促甲状腺激素(thyroid stimulating hormone,TSH)差异无统计学意义,治疗后1个月及3个月与治疗前差值比较差异均无统计学意义(均P>0.05)。治疗前Graves病组与桥本毒症组游离三碘甲状腺原氨酸(free triiodothyronine,FT3)分别为(24.09±9.29)、(17.41±9.36)pmol/L,游离甲状腺素(free thyroxine,FT4)分别为(60.23±20.82)、(43.47±21.71)pmol/L,收缩峰值流速(peak stolie vloiy,PSV)分别为(69.53±5.70)、(52.65±4.64)cm/s,两组比较差异均有统计学意义(t值分别为3.39、3.74,Z=13.83,均P<0.001);Graves病组与桥本毒症组治疗1个月与治疗前差值FT3分别为(-6.36±5.32)、(-12.64±9.08)pmol/L(t=4.02,P<0.001),治疗3个月与治疗前差值FT3分别为(-10.14±9.50)、(-17.80±11.17)pmol/L(t=3.51,P<0.001);Graves病组与桥本毒症组治疗1个月与治疗前差值FT4分别为(-28.47±10.09)、(-20.57±14.48)pmol/L(t=7.01,P<0.001),治疗3个月与治疗前差值FT4分别(-47.06±20.57)、(-30.17±20.54)pmol/L(t=3.91,P<0.001);Graves病组与桥本毒症组PSV治疗1个月与治疗前差值分别为[-13.10(-34.10,-2.60)]、[-10.50(-27.5,-0.20)]cm/s(Z=2.63,P=0.009),3个月与治疗前差值分别为[-31.40(-53.20,-12.70)]、[-19.90(-46.00,-4.70)cObjective To investigate the changes of thyroid hormones and the flow velocity of superior thyroid artery in patients with Graves'disease and Hashimoto's thyrotoxicosis before and after treatment with methimazole.Methods A case-control study was conducted to select 45 cases of Graves'disease and 45 cases of Hashimoto's thyroiditis from October 2021 to December 2022 in the Department of Endocrinology,North China University of Science and Technology Affiliated Hospital.The changes of thyroid hormone and blood flow velocity of superior thyroid artery in patients with Graves'disease and Hashimoto's thyroiditis before and after treatment with methimazole were analyzed.Measurement data satisfying normal distribution were expressed by x¯±s,and the mean between two groups was compared by t test.Measurement data not satisfying normal distribution were expressed by M(Q_(1),Q_(3)),and the median between two groups was compared by Wilcoxon rank sum test.χ^(2)test was used to compare the constituent ratio of enumeration data among groups.Results There was no significant difference in thyroid stimulating hormone(TSH)between the two groups before treatment,and there was no significant difference in TSH between the two groups after 1 month and 3 months of treatment(all P>0.05).The levels of free triiodothyronine(FT3)were(24.09±9.29)pmol/L and(17.41±9.36)pmol/L in Graves'disease group and Hashimoto's thyroiditis group respectively before treatment.FT4 were(60.23±20.82)and(43.47±21.71)pmol/L,respectively,and the peak stolie vloiy(PSV)were(69.53±5.70)and(52.65±4.64)cm/s,respectively in Graves'disease group and Hashimoto's thyroiditis group respectively before treatment.There were significant differences between the two groups(t values wrere 3.39 and 3.74,Z=13.83,all P<0.001).The difference of FT3 between one month after treatment and before treatment was(-6.36±5.32)and(-12.64±9.08)pmol/L(t=4.02,P<0.001)and the difference in FT3 between 3 months of treatment and before treatment was(-10.14±9.50)and(-17.80±11.17)pmol/L,r

关 键 词：弥漫性毒性甲状腺肿 桥本毒症 甲巯咪唑 甲状腺上动脉流速 甲状腺激素 

分 类 号：R581[医药卫生—内分泌]