甲巯咪唑与丙硫氧嘧啶治疗甲状腺功能亢进症的临床疗效及安全性比较  

Comparison of clinical efficacy and safety of the methimazole and propylthiouracil in the treatment of hyperthyroidism

作　　者：初晓芳 张世新 李滨 CHU Xiaofang;ZHANG Shixin;LI Bin(Department of Endocrinology,Zaozhuang Hospital,Shandong Guoxin Yiyang Health Group,Zaozhuang,Shandong,277100,China)

机构地区：[1]山东国欣颐养集团枣庄医院内分泌科,山东枣庄277100

出　　处：《当代医学》2024年第34期102-106,共5页Contemporary Medicine

摘　　要：目的探讨甲巯咪唑(methimazole,MMI)、丙硫氧嘧啶(propylthiouracil,PTU)治疗甲状腺功能亢进症(甲亢)的临床疗效。方法选取2021年1—12月山东国欣颐养集团枣庄医院收治的100例甲亢患者作为研究对象,采用随机数字表法分为对照组与观察组,每组50例。对照组行PTU治疗,观察组行MMI治疗。比较两组临床疗效、治疗前后甲状腺功能指标[促甲状腺激素(thyroid stimulating hormone,TSH)、游离甲状腺素(free thyroxine,FT4)、游离三碘甲状腺原氨酸(free triiodothyronine,FT3)]、甲状腺抗体指标[促甲状腺激素受体抗体(thyroid stimulating hormone receptor antibody,TRAb)、抗甲状腺球蛋白抗体(anti-thyroglobulin antibody,TgAb)、甲状腺过氧化物酶抗体(thyroid peroxidase antibody,TPOAb)]、肝功能指标[碱性磷酸酶(alkaline phosphatase,ALP)、丙氨酸转氨酶(alanine aminotransferase,ALT)、天冬氨酸转氨酶(aspartate aminotransferase,AST)]、炎症因子[转化生长因子-β1(transforming growth factor-β1,TGF-β1)、白细胞介素-2(interleukin-2,IL-2)、白细胞介素-6(interleukin-6,IL-6)]、症状缓解时间、不良反应发生率。结果观察组治疗总有效率为94.00%,高于对照组的78.00%,差异有统计学意义(P<0.05)。治疗6个月后,观察组血清TSH水平高于对照组,FT4、FT3水平均低于对照组,差异有统计学意义(P<0.05)。治疗6个月后,观察组TRAb、TgAb、TPOAb水平均低于对照组,差异有统计学意义(P<0.05)。治疗6个月后,观察组血清ALP、ALT、AST水平均低于对照组,差异有统计学意义(P<0.05)。治疗6个月后,观察组血清TGF-β1、IL-6水平均低于对照组,IL-2水平高于对照组,差异有统计学意义(P<0.05)。观察组激动烦躁、怕热多汗、食欲亢进、乏力缓解时间均短于对照组,差异有统计学意义(P<0.05)。两组不良反应发生率比较差异无统计学意义。结论MMI治疗甲亢的临床疗效显著,能抑制炎症反应,改善甲状腺功能,缩短症状�Objective To explore the clinical efficacy of methimazole(MMI)and propylthiouracil(PTU)in the treatment of hyperthyroidism.Methods A total of 100 patients with hyperthyroidism admitted to Zaozhuang Hospital,Shandong Guoxin Yiyang Health Group from January to December 2021 were selected as the study subjects,and they were divided into the control group and observation group by random number table method,with 50 cases in each group.The control group received PTU treatment,and the observation group received MMI treatment.The clinical efficacy,thyroid function index(thyroid stimulating hormone[TSH],free thyroxine[FT4]and free triiodothyronine[FT3]),thyroid antibody indicators(thyroid stimulating hormone receptor antibody[TRAb],anti-thyroglobulin antibody[TgAb],thyroid peroxidase antibody[TPOAb]),liver function indicators(alkaline phosphatase[ALP],alanine aminotransferase[ALT],aspartate aminotransferase[AST]),inflammatory factors(transforming growth factor-β1[TGF-β1],interleukin-2[IL-2],interleukin-6[IL-6])before and after treatment,symptom remission time,adverse reactions were compared between the two groups.Results The total effective rate of treatment in the observation group was 94.00%,which was higher than 78.00%in the control group,and the difference was statistically significant(P<0.05).After 6 months of treatment,the serum TSH level in the observation group was higher than that in the control group,and the serum FT4 and FT3 levels were lower than those in the control group,and the differences were statistically significant(P<0.05).After 6 months of treatment,the TRAb,TgAb and TPOAb levels in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).After 6 months of treatment,the serum ALP,ALT and AST levels in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).After 6 months of treatment,the levels of TGF-β1 and IL-6 in the observation group were lower than those in the

关 键 词：甲巯咪唑 丙硫氧嘧啶 甲状腺功能亢进症 甲状腺功能 肝功能 不良反应 

分 类 号：R58[医药卫生—内分泌]