甲硫咪唑和丙基硫氧嘧啶治疗老年甲状腺功能亢进疗效比较

Comparison of the efficacy of methimazole and propylthiouracil in the elderly patients wih thyrotoxicosis

目的比较2种药物治疗老年甲状腺功能亢进(甲亢)的疗效和安全性,为临床用药提供指导。方法选取2013年1月至2015年1月期间我院收治的100例甲亢患者作为研究对象,随机分为2组:甲硫咪唑治疗组(MMI组)50例,丙基硫氧嘧啶治疗组(PTU组)50例,选取同一时期来我院进行健康体检者50例作为对照组。比较各组的临床疗效和不良反应发生情况。结果 MMI组患者的治疗有效率为96.0%,PTU组为94.0%,差异无统计学意义(P>0.05)。MMI组不良反应发生率为32.00%,PTU组为34.0%,差异无统计学意义(P>0.05)。MMI组血细胞减少和肝功能损害发生率分别为24.0%、4.0%,PTU组分别为6.0%和22.0%,差异具有统计学意义(P<0.05)。2组患者治疗后的甲状腺功能指标与对照组比较,差异均无统计学意义(P>0.05),治疗后的血常规和肝功能指标与治疗前比较,差异具有统计学意义(P<0.05)。结论甲硫咪唑和丙基硫氧嘧啶咪治疗老年甲亢的疗效均较为理想,但二者均具有一定的不良反应,临床上应根据患者的情况慎重用药。

Objective To compare the clinical efficacy and security of methimazole and propylthiouracil in the elderly patients with thyrotoxicosis. Methods From January 2013 to January 2015, 100 elderly patients with thyrotoxicosis were selected and divided into two groups randomly,50 in methimazole gruoup（ MMI group） and 50 in propylthiouracil group（ PTU group）. At the same time,50 healthy people were chosen as control group. The clinical efficacy and rate of adverse reaction were observed and compared. Results The effect rate was 96. 0% in MMI group,and 94. 0% in PTU group,the difference between two groups had no statistical significance（ P〉0. 05）. In MMI group,the rate of side reaction was 32. 0%,compared with 34. 0% in PTU group（ P〉0. 05）. The rates of cytopenia and liver dysfunction were 24. 0% and 4. 0% in MMI group respectively; compared with 4. 00% and 22. 00% in PTU group,and the difference had statistical significance（ P〈0. 05）. After treatment,the levels of FT3,FT4 and TSH of two groups had no statistical difference with control group（ P〉0. 05）.There were statistical difference in the levels of RBC,WBC,PLT,ALT and AST between two thyrotoxicosis groups after treatment（ P〈0. 05）. Conclusions Methimazole and propylthiouracil are both effective for elderly patients with thyrotoxicosis,but both of them have adverse reaction.