甲巯咪唑与糖皮质激素联合治疗甲状腺功能亢进症合并症的临床疗效观察

Clinical Efficacy of Methimazole Combined with Glucocorticoid in the Treatment of Complications of Hyperthyroidism

目的探讨甲巯咪唑与糖皮质激素联合治疗甲状腺功能亢进症合并症的临床疗效。方法收集2016年3月至2017年10月入院的108例甲状腺功能亢进症合并症患者,随机分为两组,甲巯咪唑组患者给予单独甲巯咪唑,联合组患者给予甲巯咪唑加用糖皮质激素,比较两组患者甲状腺激素、相关抗体水平、总体治疗效果、体质量、心率、肝功指标与远期预后。结果联合组患者治疗后T3、T4、FT3、FT4、TRAb、TMAb、TGAb、心率、AST与ALT水平组间比较均显著性低于甲巯咪唑组,TSH水平显著性高于甲巯咪唑组;末期随访生理功能、总体健康与活力评分均显著性高于甲巯咪唑组,存在显著性差异(P<0.01);总有效率明显高于甲巯咪唑组,存在明显差异(P<0.05)。结论甲巯咪唑与糖皮质激素联合治疗甲状腺功能亢进症合并症的临床疗效显著,具有借鉴意义。

Objective To investigate the clinical efficacy of methimazole and glucocorticoid in the treatment of complica-tions of hyperthyroidism. Methods One hundred and eight patients with hyperthyroidism admitted to our hospital between March 2016 and October 2017 were randomly divided into two groups. Patients in the methimazole group were given methimazole alone while those in the combined group were treated with methimazole plus glucocorticoids hormones. Levels of thyroid hormones and related antibodies, overall therapeutic effect, body weight, heart rate, liver function indexes and long-term prognosis were com-pared between the two groups. Results The levels of T3, T4, FT3, FT4, TRAb, TMAb, TGAb, heart rate, AST and ALT in the combined group were significantly lower than those in the methimazole group, but the TSH level was significantly higher （P〈0. 01）. The total effective rate was significantly higher than that of the methimazole group, and there was significant differ-ence between the two groups （P〈0. 05）. Conclusion The clinical efficacy of combination of methimazole and glucocorticoids in the treatment of hyperthyroidism complications is significant. This approach is of reference value.