观察不同剂量甲巯咪唑治疗Graves病的疗效及其对促甲状腺激素受体抗体（TRAb）的影响分析

Different doses of methimazole for Graves＇ disease and its impact on thyrotropin receptor antibody（TRAb）

目的 观察大剂量单次给予甲巯咪唑及小剂量多次给予甲巯咪唑治疗Graves病的疗效及安全性,并研究两种剂量对于促甲状腺激素受体抗体（TRAb）的影响.方法 80例来我院就诊的患者均签署治疗知情同意书,将其随机均分为两组,A组为大剂量单次组（15 mg/次,1次/d）,B组为小剂量多次组（10 mg/次,3次/d）.治疗3个月后观察各组临床疗效、甲状腺激素、TRAb水平变化及副反应情况.结果 治疗3月后,两组激素水平、临床疗效及TRAb水平均低于治疗前（P＜0.05）,两组之间临床疗效及TRAb水平差异无统计学意义（P＞0.05）,A组副反应,如皮疹、肝功损害、药物性甲减及粒细胞减少等,较B组明显下降（P＜0.05）.结论 大剂量单次给予甲巯咪唑可有效治疗Graves病,且相对于小剂量多次给药可减少副反应的发生.

Objective To observe the efficacies and safety of methimazole with a single large dose or repeated small doses of administration in the treatment of Graves＇ disease and study the impact of the 2 methods on thyrotropin receptor antibody （TRAb）.Methods 80 patients all signed informed consent and then were randomly divided into group A and B.Group A was single large dose group （15 mg/times,1 times/d）;group B was multiple small dose group （10 mg/time,3 times/d）.The clinical efficacy,hormone levels,TRAb levels,and side effects were observed after 3 months＇ treatment.Results After 3 months＇ treatment,the hormone levels,clinical efficacy,and TRAb levels were markedly lower than that before the treatment in both groups（P ＜ 0.05）; there was no statistical difference in clinical efficacy and TRAb level between the two groups （P ＞ 0.05）; but fewer patients occurred side effects （such as rash,liver damage,drug-induced hypothyroidism,and neutropenia） in group A than in group B（P ＜ 0.05）.Conclusions Single large dose of methimazole is effective in the treatment of Graves＇ disease and has fewer side effects than repeated small dose.