甲巯咪唑联合糖皮质激素治疗甲状腺功能亢进症合并肝功能损害的临床疗效观察

The clinical effect of methimazole combined with glucocorticoids in the treatment of thyroid function hyperthyroidism complicated with liver function damage

目的探讨甲巯咪唑联合糖皮质激素治疗甲状腺功能亢进症合并肝功能损害的临床疗效。方法选择2013年1月~2016年6月在我院诊断治疗的甲状腺功能亢进症合并肝功能损害患者120例为研究对象。将患者随机分为联合组与甲巯咪唑组,各60例。甲巯咪唑组口服甲巯咪唑治疗;联合组口服甲巯咪唑联合糖皮质激素治疗。入组时以及治疗2周后检测FT3、FT4、AST、ALT。结果两组治疗后FT3、FT4均较治疗前显著下降,差异有统计学意义(P<0.05);治疗后联合组FT3、FT4水平显著低于甲巯咪唑组,差异有统计学意义(P<0.05)。两组治疗后AST及ALT水平均较治疗前显著下降,差异有统计学意义(P<0.05);治疗后联合组AST及ALT水平显著低于甲巯咪唑组,差异有统计学意义(P<0.05)。结论甲巯咪唑联合糖皮质激素治疗甲状腺功能亢进症合并肝功能损害能有效改善患者甲状腺功能指标及肝功能指标。

Objective To discuss the clinical effect of methimazole combined with glucocorticoids in the treatment of thyroid function hyperthyroidism complicated with liver function damage. Methods A total of 120 cases with thyroid function hyperthyroidism complicated with liver function damage from Jan 2013 to Jun 2016 in our hospital were selected as subjects. All cases were randomly divided into combination group and methimazole group, each of 60 cases. Methimazole group was treated with methimazole; combination group was treated with methimazole combined with glu- cocorticoids. FT3, FT4, AST, ALT of two groups before treatment and two weeks after treatment were detected. Results After treatment, FT3, FT4 of two groups were lower than those before treatment, which showed significant difference（P〈 0.05）; After treatment, FT3, FT4 of combination group were lower than those of the methimazole group, which showed significant difference（P〈0.05）. After treatment, AST and ALT levels of two groups were lower than those before treatment, which showed significant difference（P〈0.05）; After treatment, AST and ALT of combination group were lower than those of the methimazole group, which showed significant difference（P〈0.05）. Conclusion Methimazole combined with gluco- corticoids in the treatment of thyroid function hyperthyroidism complicated with liver function damage can reduce thy- roid function index and liver function index.