甲巯咪唑长期治疗甲亢疗效观察

Clinical Observation of Long-term Treatment of Methimazole for Hyperthyroidism

目的探讨长期使用甲疏咪唑(MMI)治疗甲亢的疗效和安全性。方法回故性分析本院收治的68例甲亢患者。其中34例自愿接受MMI长期治疗患者为观察组,口服治疗剂量MMI,症状缓解后改为维持剂量MMI长期服用;另外34例患者为对照组,口服治疗剂量MMI,症状缓解后停用,甲亢复发时再行用药。所有患者均完成3年治疗及随访,根据各组临床有效率,甲状腺功能和免疫状态改进,以及不良反应评价治疗疗效和安全性。结果治疗后,观察组患者临床有效率,各项甲状腺功能、免疫指标均显著优于对照组(P<0.05),甲亢临床复发率显著低于对照组(P<0.05);3年观察期内,观察组有5例粒细胞减少,1例药物性皮疹,对照组相应比例为3例、2例,均可在停止用药后3周内自行缓解,未见其他明显不良反应。结论 MMI长期口服可显著改善甲亢患者甲状腺功能,且无明显毒副作用,临床安全可靠。

Objective To explore the efficacy and safey of long-term use of imidazole for the treatment of hyperthyroidism. Methods 68 cases of patients with hyperthyriodism were analyzed retrospectively. 34 cases accepted long-term methimazole treatment voluntarily were called observation group and given oral methimazole in a treatment dose which changed into a maintenance dose after symptoms relief. While the other 34 cases patients given oral methimazole in a treatment dose and stoped drug after symptoms relief were called the control group. All patients were completed three years treatment and follow-up, and the treatment efficacy and safety were evaluated according to the clinical efficient, thyroid function, immune status improvement and adverse reaction. Results The observation group had more curative effect with a higher effciency and better thyroid function after the treatment（P0.05）, and the hyperthyroidism clinical recurrence rate in observation group was significantly lower than that in control group （P0.05）. During the 3 years period of observation, there were 5 cases of granulocytopenia and 1 case of drug rash in the observation group, while the corresponding control ratio in the control group were 3 cases and 2 cases, and all the untoward effects could eased in three weeks spontaneously without other obvious adverse reaction. Conclusion Long-term use of oral methimazole can significantly improve the thyroid function in patients with hyperthyroidism thyroid function, and has no obvious side effects, which is safe and reliable in clinic.