普萘洛尔与美托洛尔联合甲巯咪唑治疗甲状腺功能亢进合并心房颤动的效果比较

Comparison of effects of Propranolol and Metoprolol combined with Methimazole in treatment of hyperthyroidism with atrial fibrillation

目的:比较普萘洛尔与美托洛尔联合甲巯咪唑治疗甲状腺功能亢进(甲亢)合并心房颤动(房颤)的效果。方法:选取100例甲亢合并房颤患者为研究对象。按随机数字表法将其分成对照组与研究组各50例,对照组采用酒石酸美托洛尔片联合甲巯咪唑片治疗,研究组采用盐酸普萘洛尔片联合甲巯咪唑片治疗。比较两组临床疗效、治疗前后甲状腺激素水平、平均动脉压、心率与不良反应发生率。结果:研究组治疗总有效率为98.0%(49/50),高于对照组的84.0%(42/50),差异有统计学意义(P<0.05);研究组治疗后的游离三碘甲状腺原氨酸、游离甲状腺素水平及平均动脉压、心率低于对照组,促甲状腺激素水平高于对照组,差异均有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:普萘洛尔联合甲巯咪唑治疗甲亢伴房颤患者效果优于美托洛尔联合甲巯咪唑,可有效改善房颤症状,降低甲状腺激素水平。

Objective:To compare effects of Propranolol and Metoprolol combined with Methimazole in treatment of hyperthyroidism with atrial fibrillation.Methods:100 patients with hyperthyroidism and atrial fibrillation were selected as the research objects,and divided into control group and study group according to the random number table method,each with 50 cases.The control group was treated with Metoprolol tartrate tablets combined with Methimazole tablets,while the study group was treated with Propranolol hydrochloride tablets combined with Methimazole tablets.The clinical efficacy,thyroid hormone levels before and after the treatment,mean arterial pressure,heart rate and adverse reactions were compared between the two groups.Results:The effective rate of treatment in the study group was 98.0%(49/50),which was higher than the control group of 84.0%(42/50),and the difference was statistically significant(P<0.05).After the treatment,the levels of free triiodothyronine and free thyroxine,mean arterial pressure and heart rate of the study group were lower than those of the control group;the thyrotropin level was higher than that of the control group;and the differences were statistically significant(P<0.05).However,there was no statistically significant difference in the adverse reactions between the two groups(P>0.05).Conclusions:Propranolol combined with Methimazole is superior to Metoprolol combined with Methimazole in the treatment of the patients with hyperthyroidism and atrial fibrillation.It can effectively improve the symptoms of atrial fibrillation and reduce the patients’thyroid hormone levels.