摘要
目的:探讨甲巯咪唑联合普萘洛尔治疗对轻中度甲状腺功能亢进症(甲亢)患者甲状腺功能、血清皮质醇(cortisol, COR)、促肾上腺皮质激素(adrenocorticotropic hormone, ACTH)水平的影响。方法:选择我院2017年1月-2018年1月诊治的88例轻中度甲亢,按照随机数字表法分为观察组与对照组,每组各44例。对照组予甲巯咪唑治疗,观察组予甲巯咪唑联合普萘洛尔治疗,均治疗3个月。比较临床疗效,检测治疗前后血清促甲状腺激素(thyroid stimulating hormone, TSH)、游离三碘甲状腺素(free triiodothyronine, FT 3)、游离甲状腺素(free thyroxine, FT 4)、COR、ACTH水平变化,观察治疗前后心率变化,记录不良反应发生情况。结果:观察组、对照组治疗总有效率分别为95.45%(42/44)、81.82%(36/44),比较差异有统计学意义(χ^ 2=4.061, P =0.044)。与对照组比较,观察组治疗后TSH、COR水平升高,FT 3、FT 4、ACTH水平与心率降低,差异有统计学意义( P <0.001);与本组治疗前比较,两组治疗后TSH、COR水平明显升高,FT 3、FT 4、ACTH水平与心率显著降低,差异有统计学意义( P <0.001)。两组不良反应发生率比较差异无统计学意义( P =1.000)。结论:甲巯咪唑联合普萘洛尔治疗轻中度甲亢疗效较好,不良反应少,可明显改善甲状腺功能,提高血清COR水平,降低ACTH水平。
Objective To investigate the effect of methimazole combined with propranolol on thyroid function, serum cortisol (COR) and adrenocorticotropic hormone (ACTH) in patients with hyperthyroidism (IIH). Methods Eighty-eight patients with mild to moderate hyperthyroidism treated in the hospital from January 2017 to January 2018 were selected. They were randomly divided into the observation group and the control group by random number table, with 44 cases in each group. The control group was treated with methimazole, and the observation group was treated with methimazole combined with propranolol. The course of treatment was 3 months for both groups. Clinical efficacy was evaluated in the two groups. Changes in levels of serum thyroid stimulating hormone (TSH), free triiodothyronine (FT 3), free thyroxine (FT 4), COR and ACTH of the two groups were compared before and after treatment, and heart rate (HR) was monitored. In addition, adverse reactions were recorded. Results The total effective rate of treatment in observation group was significantly higher than that in the control group (95.45%vs 81.82%, P <0.05). As compared with control group, levels of serum TSH and COR in observation group were significantly increased while levels of FT 3, FT 4 and ACTH and HR were significantly decreased after treatment ( P <0.05). As compared with those before treatment, changes of above indicators in both groups were more pronounced, and significant differences were noted ( P <0.01). There was no statistically significant difference in the incidence of adverse reactions between the two groups ( P =1.000). Conclusion Meridazole combined with propranolol is effective in the treatment of mild to moderate hyperthyroidism with few adverse reactions. It can significantly improve the thyroid function, increase serum COR levels and decrease ACTH levels.
作者
王萍
何晓俐
何谦
龙婷
苏明
WANG Ping;HE Xiao-li;HE Qian;LONG Ting;SU Ming(Outpatient Department of West China Hospital, Sichuan University, Chengdu 610041, China)
出处
《临床误诊误治》
2019年第6期33-36,共4页
Clinical Misdiagnosis & Mistherapy
基金
四川省科技厅基金项目(2017RZ0040)
