小剂量甲巯咪唑治疗甲状腺功能亢进症患者的疗效及对甲状腺体积、降钙素水平的影响  

The therapeutic effect of low-dose methimazole on hyperthyroidism patients and its impact on thyroid volume and calcitonin levels

作　　者：黄婧 叶文春 方向明 谯艳 李娟 Huang Jing;Ye Wenchun;Fang Xiangming;Qiao Yan;Li Juan(Department of Endocrinology,Mianyang Central Hospital,School of Medicine,University of Electronic Science and Technology of China,Mianyang 621000,China;Department of Ultrasound,Mianyang Central Hospital,School of Medicine,University of Electronic Science and Technology of China,Mianyang 621000,China)

机构地区：[1]电子科技大学医学院附属绵阳医院绵阳市中心医院内分泌科,绵阳621000 [2]电子科技大学医学院附属绵阳医院绵阳市中心医院超声科,绵阳621000

出　　处：《中国医师杂志》2024年第4期560-563,共4页Journal of Chinese Physician

基　　金：四川省卫生信息学会科研课题(2019006)。

摘　　要：目的分析小剂量甲巯咪唑治疗对甲状腺功能亢进症(简称甲亢)患者甲状腺体积及降钙素水平的影响。方法选取2019年1月至6月在绵阳市中心医院诊治的100例甲亢患者,采用随机数字表法将患者分为对照组(50例)和观察组(50例)。对照组给予甲巯咪唑1次/d、30 mg/次治疗,观察组给予甲巯咪唑2次/d、10 mg/次治疗,比较两组患者治疗前后的甲状腺体积、甲状腺功能[甲状腺生长激素(TSH)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)和促甲状腺激素受体抗体(TRAb)]及血清降钙素(CT)、内脂素(Visfatin)、肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)水平的变化。比较两组的临床疗效。结果观察组临床总有效率高于对照组(P<0.05)。治疗后,观察组甲状腺体积显著小于对照组,CT水平显著低于对照组(均P<0.05)。治疗后,观察组TSH水平明显高于对照组,FT3、FT4、TRAb水平明显低于对照组(均P<0.05)。治疗后,观察组Visfatin、TNF-α、IL-6水平明显低于对照组(均P<0.05)。结论小剂量甲巯咪唑可改善甲亢患者甲状腺功能,缩小甲状腺体积,降低机体CT及炎症因子水平,疗效较佳。Objective To analyze the effects of low-dose methimazole treatment on thyroid volume and calcitonin levels in patients with hyperthyroidism.Methods A total of 100 hyperthyroidism patients who were treated at the Mianyang Central Hospital from January to June 2019 were selected and randomly divided into a control group(50 cases)and an observation group(50 cases)using a random number table method.The control group was treated with once a day and 30 mg/dose of methimazole,while the observation group was treated with twice a day and 10 mg/dose of methimazole.Thyroid volume,and thyroid function[Thyroid growth hormone(TSH),free triiodothyronine(FT3),free thyroxine(FT4),and thyroid stimulating hormone receptor antibody(TRAb)]before and after treatment in two groups of patients,the changes in serum levels of calcitonin(CT),visfatin,tumor necrosis factor-α(TNF-α),and interleukin-6(IL-6)were compared.The clinical efficacy of two groups were also compared.Results The total clinical effective rate of the observation group was higher than that of the control group(P<0.05).After treatment,the thyroid volume in the observation group was significantly smaller than that in the control group,and the CT level was significantly lower than that in the control group(all P<0.05).After treatment,the TSH level in the observation group was significantly higher than that in the control group,while the levels of FT3,FT4,and TRAb were significantly lower than those in the control group(all P<0.05).After treatment,the levels of Visfatin,TNF-α,and IL-6 in the observation group were significantly lower than those in the control group(all P<0.05).Conclusions Low dose methimazole can improve thyroid function,reduce thyroid volume,lower body CT and inflammation levels in patients with hyperthyroidism,and has a better therapeutic effect.

关 键 词：甲巯咪唑 甲状腺功能亢进症 降钙素 甲状腺功能试验 

分 类 号：R581.1[医药卫生—内分泌]