探讨丙硫氧嘧啶与甲巯咪唑治疗甲状腺功能亢进的临床疗效

Investigation on the Clinical Efficacy of Propylthiouracil and Methimazole in the Treatment of Hyperthyroidism

目的探讨丙硫氧嘧啶与甲巯咪唑治疗甲状腺功能亢进的临床疗效。方法方便选取该院2015年3月—2018年6月收治的80例甲状腺功能亢进患者,将其随机分为两组各40例,对照组采用甲巯咪唑(初始剂量10mg/次,tid,症状改善后调整为10mg/次,bid)治疗,观察组采用丙硫氧嘧啶(起始剂量100mg/次,tid,症状改善后调整至10mg/次,bid)治疗,4个月后比较两组患者治疗效果、不良反应发生情况和治疗后肝功能损伤情况。结果观察组治疗有效率为92.50%,对照组为87.50%,两组治疗有效率比较差异无统计学意义(χ^2=0.138,P>0.05);观察组血细胞计数减少发生率(2.50%)明显低于对照组(40.00%),差异有统计学意义(χ^2=16.806,P<0.05),肝功能异常发生率(22.50%)明显高于对照组(2.50%),差异有统计学意义(χ^2=7.314,P<0.05);治疗后观察组肝功能损伤发生率(25.00%)明显高于对照组(7.50%),差异有统计学意义(χ^2=5.541,P<0.05),肝损伤发生时间明显长于对照组,差异有统计学意义(t=19.155,P<0.05)。结论丙硫氧嘧啶与甲巯咪唑治疗甲状腺功能亢进疗效相当,均可有效改善患者临床症状,但前者容易发生肝功能损伤,后者容易发生血小板计数减少现象,应结合患者病况合理制定用药方案。

Objective To investigate the clinical efficacy of propylthiouracil and methimazole in the treatment of hyperthyroidism.Methods Eighty patients with hyperthyroidism admitted to the hospital from March 2015 to June 2018 who were conveniently selected in the study were randomly divided into two groups,with 40 patients in each group.The control group was treated with methimazole(initial dose 10 mg/time,tid,symptom improvement;after adjustment to 10 mg/time,bid)treatment,the observation group was treated with propylthiouracil(starting dose 100 mg/time,tid,adjusted to 10 mg/time,bid),and after 4 months,the two groups were compared of effects,adverse events,and liver function damage after treatment.Results The effective rate was 92.50%in the observation group and 87.50%in the control group.There was no statistically significant difference in the effective rate between the two groups(χ^2=0.138,P>0.05).The incidence of blood cell count decreased in the observation group(2.50%)significantly lower than the control group(40.00%),the difference was statistically significant(χ^2=16.806,P<0.05),the incidence of abnormal liver function(22.50%)was significantly higher than the control group(2.50%),the difference was statistically significant(χ^2=7.314,P<0.05);The incidence of liver function injury in the observation group after treatment(25.00%)was significantly higher than that in the control group(7.50%),the difference was statistically significant(χ^2=5.541,P<0.05),and the time of liver injury was significantly longer than the control group,the difference was statistically significant(t=19.155,P<0.05).Conclusion Both propylthiouracil and methimazole are effective in treating hyperthyroidism,which can effectively improve the clinical symptoms of patients.However,the former is prone to liver damage,and the latter is prone to decrease platelet count.The drug regimen should be formulated in accordance with the patient's condition.