摘要
目的 观察甲硫咪唑联合左甲状腺素治疗儿童甲状腺功能亢进症的临床效果及安全性.方法 选择58例甲状腺功能亢进儿童患者,给予甲硫咪唑治疗2～3个月,当甲状腺功能正常后随机平均分为对照组和研究组各29例,对照组继续甲硫咪唑治疗,研究组给予甲硫咪唑联合左甲状腺素治疗,分别于治疗前,治疗后第2、6、12个月检测游离三碘甲腺原氨酸（FT3）、游离甲状腺素（FT4）、促甲状腺激素（TSH）、甲状腺体积,并观察不良反应发生情况.结果 治疗2个月后,两组患者的FT3、FT4、TSH均基本恢复至正常水平（P＜0.05）,但对甲状腺体积改变不明显（P＞0.05）;治疗6个月后,研究组患者的TSH水平较对照组明显降低,甲状腺体积较对照组明显减小,差异有统计学意义（P＜0.05）.研究组药物性甲减发生率为3.4％,显著低于对照组的17.2％,差异有统计学意义（P＜0.05）.结论 甲硫咪唑联合左甲状腺素治疗儿童甲状腺功能亢进症临床效果确切,能使FT3、FT4、TSH恢复正常水平,且继发性药物甲减发生率较低,值得临床推广和普及.
Objective To observe the clinical effect and safety of methimazole combined with levothyroxine in the treatment of hyperthyroidism in children. Methods 58 children patients with hyperthyroidism were selected and treated by methimazole for 2 to 3 months.After thyroid function being normal,they were evenly divided into control group and research group,29 cases in each group.Methimazole was continue used in control group,while methimazole combined with levothyroxine was applied to research group.Free triiodothyronine （FT3）,free thyroxine （FT4）,thyroid-stimulating hor- mone （TSH）,and volume of thyroid was tested before treatment,2nd,6th,and 12th month treatment in both groups.In addi- tion,occurrence of adverse reaction was observed. Results After two months treatment,FT3,FT4,TSH in both groups was recovered to normal level （P〈0.05）,but there was no significant changes about thyroid volume （P〉0.05）;After 6 months treatment,level of TSH decreased more remarkably and volume of thyroid became smaller in the research group com- pared with that in the control group,the difference was significant （P〈0.05）.In the research group,incidence of hypothy- roidism induced by drug was 3.4%,lower than 17.2% in the control group,the difference was significant （P〈O.05）. Con- dusion Combination of methimazole and levothyroxine can obtain a definite effect on treating children patients with hy- perthyroidism in clinic.It can return FT3,FT4,and TSH to normal levels,and the incidence of secondary hypothyroidism induced by drug is low,which is worthy of expansion in clinic.
出处
《中国当代医药》
2014年第34期64-66,共3页
China Modern Medicine
