摘要
目的观察地塞米松联合甲巯咪唑对慢性自身免疫性甲状腺炎的临床疗效及安全性。方法将36例慢性自身免疫性甲状腺炎患者随机分成试验组18例及对照组18例。对照组予以口服甲巯咪唑10 mg tid;试验组在对照组治疗的基础上,于治疗第1,8,15,22天甲状腺内肌内注射地塞米松5 mg。2组患者均治疗28 d。比较2组的临床疗效、治疗前后血清T淋巴细胞、肿瘤坏死因子α(TNF-α)水平、血清人促甲状腺素(TSH)、游离三碘甲状腺原氨酸(FT_3)、游离甲状腺素(FT_4)、抗甲状腺过氧化物酶抗体(TPOAb)和抗甲状腺球蛋白抗体(TGAb)等指标水平及药物不良反应发生情况。结果试验组和对照组的总有效率分别为94.44%(17例/18例)和66.67%(12例/18例),差异有统计学意义(P<0.05);治疗后,试验组和对照组的CD4^+/CD8^+分别为1.31±0.07,1.00±0.08;TNF-α分别为(1.57±0.16),(1.92±0.16)ng·mL^(-1);FT_3分别为(2.85±0.78),(5.19±1.04)pmol·L^(-1);FT_4分别为(13.08±1.59),(18.96±2.21)pmol·L^(-1);TSH分别为(2.88±0.60),(3.85±0.81)U·mL^(-1);TPOAb分别为(22.92±3.30),(27.43±4.45)U·mL^(-1);TGAb分别为(74.30±11.22),(92.74±13.46)U·mL^(-1);差异均有统计学意义(均P<0.05)。试验组出现的药物不良反应有激动不安、恶心呕吐,对照组出现的药物不良反应有头晕头痛、恶心呕吐、味觉减退。试验组和对照组的药物不良反应发生率分别为11.11%(2例/18例)和22.22%(4例/18例),差异无统计学意义(P>0.05)。结论地塞米松联合甲巯咪唑治疗慢性自身免疫性甲状腺炎临床疗效较好,安全性较高。
Objective To investigate the clinical efficacy and safety profile of dexamethasone combined with methimazole in patients with chronic autoimmune thyroiditis.Methods A total of 36 patients with chronic autoimmune thyroiditis were randomly divided into treatment group（n = 18） and control group（n = 18）.The control group received oral administration of methimazole 10 mg,tid.The treatment group were given dexamethasone injection 5 mg at day 1,8,15 and 22,on the basis of the control group.Both groups were treated for 28 d.After treatment,the clinical efficacy,the levels of serum T lymphocyte,tumor necrosis factor-α（TNF-α）,thyroid stimulating hormone（TSH）,free triiodothyronine（FT3）,free thyroxine（FT4）,antithyroperoxidase antibody（TPOAb）,antithyroglobulin antibody（TGAb） and the adverse drug reactions were compared between the two groups.Results The total effective rates of the treatment group and the control group were 94.44%（17 cases/18 cases） and 66.67%（12 cases/18 cases）,respectively,and the difference was statistically significant（P 〈 0.05）.After treatment,levels of serum CD4＋/CD8＋were 1.31 ± 0.07,1.00 ± 0.08 in treatment group and control group.The levels of TNF-α were（1.57 ± 0.16）,（1.92 ± 0.16）ng·mL-1.The levels of FT3 were（2.85 ± 0.78）,（5.19 ± 1.04） pmol·L-1.The levels of FT4 were（13.08 ± 1.59）,（18.96 ± 2.21） pmol·L-1.The levels of TSH were（2.88 ± 0.60）,（3.85 ± 0.81） U·mL-1.The levels of TPOAb were（22.92 ± 3.30）,（27.43 ± 4.45） U · mL-1.The levels of TGAb were（74.30 ± 11.22）,（92.74 ± 13.46）U·mL-1,respectively.All the parameters between the two groups were statistically significant（P 〈 0.05）.The adverse drug reactions in patients of the treatment group were agitation,nausea and vomiting,and the incidence of adverse drug reactions was 11.11%（2 cases/18 cases）.The adverse drug reactions in patients of the control group were dizziness headache,nausea and vomiting,hypogeusia,and the incidence of adverse drug reaction was 22.22%（4 cases/18 cases）.There was no statistically significant differences in the incidence of adverse drug reactions between the two groups（P 〉 0.05）.Conclusion Dexamethasone combined with sulfhydryl imidazole exerted satisfying clinical efficacy and high safety profile on the treatment of chronic autoimmune thyroiditis.
出处
《中国临床药理学杂志》
CAS
CSCD
北大核心
2017年第22期2250-2253,共4页
The Chinese Journal of Clinical Pharmacology
基金
国家医学教育发展中心医学研究课题基金资助项目(2010-25-01-16)
