丙基硫氧嘧啶与甲巯咪唑治疗妊娠合并甲状腺功能亢进的疗效比较

Comparison of Propyl Thiouracil and Methimazole in the Treatment of Pregnancy with Hyperthyroidism

目的探讨妊娠合并甲状腺功能亢进患者接受丙基硫氧嘧啶和甲巯咪唑治疗的效果。方法选取2016年9月～2017年11月在我院就诊的妊娠合并甲状腺功能亢进孕妇78例,随机分为对照组和观察组,各39例。对照组采用丙基硫氧嘧啶治疗,观察组予甲巯咪唑治疗,对比两组孕妇甲状腺功能、肝损伤发生率和发生时间。结果对照组产前促甲状腺激素(TSH)、游离三碘甲状腺原氨酸(FT_3)及游离甲状腺激素(FT_4)水平分别为[(0.82±0.21)mU/L、(5.16±0.79)pmol/L、(16.98±2.21)pmol/L],低于观察组[(0.93±0.17)mU/L、(8.02±0.68)pmol/L、(21.39±3.02)pmol/L],差异有统计学意义(P<0.05);观察组肝损伤发生率低于对照组(7.69%vs 25.64%),肝损伤发生时间早于对照组[(18.75±6.78)d vs(41.67±8.31)d],差异有统计学意义(P<0.05)。结论丙基硫氧嘧啶与甲巯咪唑均可有效改善妊娠合并甲状腺功能亢进患者甲状腺功能,其中丙基硫氧嘧啶改善甲状腺功能更为显著,但其易损伤患者肝功能。

Objective To investigate the effect of propyl thiouracil and methimazole in patients with pregnancy complicated with hyperthyroidism. Methods A total of 78 pregnant women with hyperthyroidism who were admitted to our hospital from September 2016 to November 2017 were randomly divided into the control group and the observation group, 39 cases each. The control group was treated with propylthiouracil, and the observation group was treated with methimazole. The incidence of thyroid function and liver injury and the time of occurrence were compared between the two groups.Results The levels of prenatal thyroid stimulating hormone (TSH), free triiodothyronine (FT3) and free thyroid hormone (FT4) in the control group were [(0.82±0.21) mU/L,(5.16±0.79) pmol/L,(16.98±2.21,respectively) pmol/L], lower than the observation group [(0.93±0.17) mU/L,(8.02±0.68) pmol/L,(21.39±3.02) pmol/L], the difference was statistically significant(P<0.05);the incidence of liver injury in the observation group was lower than that in the control group (7.69% vs 25.64%), and the time of liver injury occurred earlier than the control group [(18.75±6.78)d vs (41.67±8.31)d],the difference was statistically significant (P<0.05). Conclusion Both propylthiouracil and methimazole can effectively improve thyroid function in patients with hyperthyroidism during pregnancy. Among them, propylthiouracil is more effective in improving thyroid function, but it is easy to damage liver function.