甲巯咪唑联合普萘洛尔治疗甲状腺功能亢进患者的疗效及安全性
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摘要
目的分析甲巯咪唑联合普萘洛尔对甲状腺功能亢进患者的疗效及对游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)和促甲状腺素(TSH)水平的影响。方法将110例甲状腺功能亢进患者采用随机数字表法均分成观察组和对照组。对观察组患者实施甲巯咪唑联合普萘洛尔治疗,对照组患者仅用甲巯咪唑治疗,比较2组的疗效以及对FT3、FT4和TSH水平的影响。结果治疗后,观察组患者疗效为优者达到58.18%(32/55),优良率为98.18%(54/55),明显高于对照组的32.73%以及74.55%(P<0.05)。观察组不良反应发生率明显小于对照组。观察组与对照组的FT3和FT4水平在治疗后均有效降低,TSH水平均有效升高,并且观察组明显优于对照组,差异具有统计学意义(P<0.05)。结论甲巯咪唑联合普萘洛尔对甲状腺功能亢进患者疗效较好,能调节FT3、FT4和TSH水平,降低不良反应发生率,安全性较高。
Objective To analyze the effect of methimazole combined with propranolol and to observe its influence on free triiodothyronine(FT3),free thyroxine(FT4) and thyrotropin(TSH) levels in hyperthyroidism patients.Methods 110 cases of hyperthyroidism patients were chosen and divided into 2 groups by digital method.The observation group was treated with methimazole combined with propranolol,while the control group were treated with methimazole alone.Efficacy and the levels of FT3,FT4 and TSH were compared between the 2 groups.Results After treatment,the good rate of observation group was 58.18%(32/55),excellent rate 98.18%(54/55),significantly higher than of the control group 32.73% and 74.55%(P<0.05).The incidence of adverse reactions in the observation group was significantly lower than in the control group.Although the levels of FT3,FT4 of both groups were effectively reduced after treatment and TSH levels effectively increased after treatment,the observation group better than the control group.The difference was statistically significant(P<0.05).Conclusion Methimazole combined with propranolol in patients with hyperthyroidism can regulate the level of TSH,FT3 and FT4,decrease the incidence of adverse reactions.
Objective To analyze the effect of methimazole combined with propranolol and to observe its influence on free triiodothyronine(FT3),free thyroxine(FT4) and thyrotropin(TSH) levels in hyperthyroidism patients.Methods 110 cases of hyperthyroidism patients were chosen and divided into 2 groups by digital method.The observation group was treated with methimazole combined with propranolol,while the control group were treated with methimazole alone.Efficacy and the levels of FT3,FT4 and TSH were compared between the 2 groups.Results After treatment,the good rate of observation group was 58.18%(32/55),excellent rate 98.18%(54/55),significantly higher than of the control group 32.73% and 74.55%(P<0.05).The incidence of adverse reactions in the observation group was significantly lower than in the control group.Although the levels of FT3,FT4 of both groups were effectively reduced after treatment and TSH levels effectively increased after treatment,the observation group better than the control group.The difference was statistically significant(P<0.05).Conclusion Methimazole combined with propranolol in patients with hyperthyroidism can regulate the level of TSH,FT3 and FT4,decrease the incidence of adverse reactions.
引文
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[9] 潘勇康,黄叶,杨欢,等.组织多普勒成像技术对甲状腺功能亢进患者右室功能的评价效果[J].广西医科大学学报,2017,34(8):1232-1234.
[10] 徐辉,史潇,李梅娜,等.术中静脉应用不同剂量右美托咪定对老年患者术后硬膜外吗啡镇痛的影响[J].中国医院药学杂志,2015,35(15):1417-1419.
[11] Kozielewicz D,Karwowska K,Dybowska D,et al.Agranulocytosis during treatment of chronic hepatitis C complicated by hyperthyreosis.Case reports[J].Endokrynol Pol,2012,63(1):52-55.
[12] Perger L,Bürgi U,Fattinger K,et al.Pharmacotherapy of hyperthyreosis-adverse drug reactions[J].Ther Umsch,2011,68(6):303-308.
[13] Gen?er N,Yavuz E.An alternative purification method for human serum paraoxonase 1 and its interaction with methidathion[J].Arch Physiol Biochem,2017,123(3):159-164.
[14] 曹喜红,黄洁,王海燕,等.临床药师参与门诊甲亢患者治疗的药学服务实践[J].西北药学杂志,2016,31(5):543-545.
[15] 陈茹芬,叶伟坚,罗剑彬,等.碘131联合甲巯咪唑对甲状腺功能亢进患者骨代谢的影响[J].中国现代医学杂志,2017,27(18):83-86.
[16] 方勇明,吕铭,曾晓春,等.甲巯咪唑联合普萘洛尔治疗甲状腺功能亢进症的疗效观察[J].中国医药科学,2017,7(9):191-193.
[17] 许杰艺,黎亮,卢雄伟,等.比较甲巯咪唑与丙硫氧嘧啶对甲状腺功能亢进症患者肝功能的影响[J].河南外科学杂志,2017,23(6):99-100.
[18] 马亚萍.比较甲巯咪唑与丙硫氧嘧啶在治疗甲状腺功能亢进过程中对患者肝功能的影响[J].检验医学与临床,2017,14(Z1):221-223.
[19] 迟鹏威.雷公藤多苷联合甲巯咪唑、强的松治疗甲亢突眼的临床分析[J].北方药学,2017,14(9):34-35.
[2] 黄立冠,熊菌.甲巯咪唑联合普萘洛尔治疗甲状腺机能亢进症患者的临床效果及其对相关激素水平的影响[J].国际移植与血液净化杂志,2017,15(2):28-29.
[3] 苏青.美国甲状腺协会/美国临床内分泌医师协会甲亢诊疗指南介绍[J].中华内分泌代谢杂志,2013,29(2):1-5.
[4] 巩东坤,李媛媛.甲亢性心脏病患者在治疗前后血脑钠肽水平的变化[J].中华全科医学,2014,12(10):1697-1699.
[5] 周腾达.甲巯咪唑联用比索洛尔治疗甲亢临床效果的研究[J].北方药学,2016,13(7):39.
[6] 刘祥秀,孔德明,代芳,等.养阴清肝散结方联合西药治疗阴虚火旺型Graves病患者的临床疗效观察及其机制研究[J].中国医院药学杂志,2017,37(10):968-971.
[7] 杜补林,李亚明,尹雅芙,等.131I治疗Graves甲亢前长时间应用抗甲状腺药物对其疗效的影响[J].中国医科大学学报,2011,40(2):146-148.
[8] 徐宗彩,唐素荣.定期随访宣教对甲亢患者ATD治疗的影响[J].标记免疫分析与临床,2017,24(5):597-600.
[9] 潘勇康,黄叶,杨欢,等.组织多普勒成像技术对甲状腺功能亢进患者右室功能的评价效果[J].广西医科大学学报,2017,34(8):1232-1234.
[10] 徐辉,史潇,李梅娜,等.术中静脉应用不同剂量右美托咪定对老年患者术后硬膜外吗啡镇痛的影响[J].中国医院药学杂志,2015,35(15):1417-1419.
[11] Kozielewicz D,Karwowska K,Dybowska D,et al.Agranulocytosis during treatment of chronic hepatitis C complicated by hyperthyreosis.Case reports[J].Endokrynol Pol,2012,63(1):52-55.
[12] Perger L,Bürgi U,Fattinger K,et al.Pharmacotherapy of hyperthyreosis-adverse drug reactions[J].Ther Umsch,2011,68(6):303-308.
[13] Gen?er N,Yavuz E.An alternative purification method for human serum paraoxonase 1 and its interaction with methidathion[J].Arch Physiol Biochem,2017,123(3):159-164.
[14] 曹喜红,黄洁,王海燕,等.临床药师参与门诊甲亢患者治疗的药学服务实践[J].西北药学杂志,2016,31(5):543-545.
[15] 陈茹芬,叶伟坚,罗剑彬,等.碘131联合甲巯咪唑对甲状腺功能亢进患者骨代谢的影响[J].中国现代医学杂志,2017,27(18):83-86.
[16] 方勇明,吕铭,曾晓春,等.甲巯咪唑联合普萘洛尔治疗甲状腺功能亢进症的疗效观察[J].中国医药科学,2017,7(9):191-193.
[17] 许杰艺,黎亮,卢雄伟,等.比较甲巯咪唑与丙硫氧嘧啶对甲状腺功能亢进症患者肝功能的影响[J].河南外科学杂志,2017,23(6):99-100.
[18] 马亚萍.比较甲巯咪唑与丙硫氧嘧啶在治疗甲状腺功能亢进过程中对患者肝功能的影响[J].检验医学与临床,2017,14(Z1):221-223.
[19] 迟鹏威.雷公藤多苷联合甲巯咪唑、强的松治疗甲亢突眼的临床分析[J].北方药学,2017,14(9):34-35.