甲巯咪唑联合左甲状腺素治疗甲状腺功能亢进患儿的临床研究

Clinical trial of methimazole combined with levothyroxine in the treatment of hyperthyroidism in children

目的分析甲巯咪唑联合左甲状腺素治疗甲状腺功能亢进患儿的疗效及安全性。方法选取我院收治的甲状腺功能亢进患儿70例,随机分为对照组和试验组,每组35例。对照组给予甲巯咪唑0.5~1 mg·kg^-1·d^-1,每天3次,口服;试验组在对照组的基础上给予左甲状腺素12.5~50μg·d^-1,每天1次,口服。2组均治疗3个月。比较2组患儿治疗后的甲状腺功能、炎性因子水平、甲状腺体积及药物不良反应发生率。结果治疗后,对照组和试验组游离三碘甲状腺原氨酸(FT3)水平分别为(4.45±1.46),(3.01±2.12)ng·L^-1;游离甲状腺素(FT4)水平分别为(25.42±4.67),(13.52±5.28)ng·L^-1;甲状腺体积为(14.72±4.27),(8.13±2.78)cm3;hs-CRP水平分别为(2.68±0.52),(2.67±0.48)mg·L^-1;IL-6水平分别为(1.97±0.64),(1.51±0.24)pg·L^-1;促甲状腺激素(TSH)水平分别为(4.11±2.67)mU·L^-1,(2.87±1.12)mU·L^-1,差异均有统计学意义(均P<0.05)。试验组药物不良反应发生率(2.86%)低于对照组(22.86%),差异有统计学意义(P<0.05)。结论甲巯咪唑联合左甲状腺素治疗甲状腺功能亢进患儿能够有效改善患儿甲状腺激素水平,缩小甲状腺体积,且安全性好。

Objective To analyze the efficacy and safety of methimazole combined with levothyroxine in the treatment of hyperthyroidism in children.Methods Seventy children with hyperthyroidism admitted to our hospital were randomly divided into control group and treatment group,35 cases in each group.Control group was given methimazole 0.5^-1 mg·kg^-1·d^-1,3 times·d^-1,oral;treatment group was given levothyroxine 12.5-50μg·d^-1,1 time·d^-1,oral,on the basis of control group.All patients were treated for 3 months.The thyroid function,thyroid function,inflammatory factor levels,thyroid volume,and incidence of adverse drug reactions after treatment were compared between the two groups.Results After treatment,the levels of free triiodothyronine(FT3)in control group and treatment group were(4.45±1.46)and(3.01±2.12)ng·L^-1,the levels of free thyroxine(FT4)were(25.42±4.67)and(13.52±5.28)ng·L^-1,the thyroid volume were(14.72±4.27)and(8.13±2.78)cm3,hs-CRP levels were(2.68±0.52)and(2.67±0.48)mg·L^-1,the levels of IL-6 were(1.97±0.64)and(1.51±0.24)pg·L^-1,the levels of thyrotropin(TSH)were(4.11±2.67)and(2.87±1.12)mU·L^-1,all with significant difference(all P<0.05).The incidence of adverse drug reactions in treatment group(2.86%)was lower than that in control group(22.86%,P<0.05).Conclusion Methiomidazole combined with levothyroxine in the treatment of hyperthyroidism patients can effectively improve the levels of thyroid hormone in patients,reduce thyroid volume,with good safety.