甲巯咪唑联合复方倍他米松治疗甲状腺功能亢进症的有效性及安全性分析

Efficacy and safety of thiamazole combined with compound betamethasone on the treatment of hyperthyroidism

目的探讨甲巯咪唑联合复方倍他米松治疗甲状腺功能亢进症的有效性及安全性。方法选取2018年8月至2020年2月海军军医大学第二附属医院内分泌科收治的80例甲状腺功能亢进症患者作为研究对象,采用随机数字表法分为对照组和观察组,各40例。对照组予甲巯咪唑片口服,观察组在对照组基础上予复方倍他米松注射液双侧甲状腺局部注射,2组均连续治疗3个月。比较2组临床疗效、甲状腺激素及相关抗体水平,记录治疗期间不良反应发生情况。结果观察组总有效率高于对照组,差异有统计学意义(P<0.001)。治疗后2组血清三碘甲状腺原氨酸、甲状腺素、游离三碘甲状腺原氨酸、游离甲状腺素、促甲状腺激素受体抗体、抗甲状腺球蛋白抗体水平均较治疗前降低,且观察组均低于对照组[(1.58±0.15)μg/L比(1.93±0.19)μg/L、(97±10)μg/L比(117±14)μg/L、(6.5±0.4)pmol/L比(9.7±0.6)pmol/L、(21.0±0.5)pmol/L比(26.6±0.6)pmol/L、(11.3±1.2)IU/L比(24.0±2.2)IU/L、(36±5)IU/L比(42±6)IU/L],差异均有统计学意义(均P<0.05)。治疗后2组血清促甲状腺激素水平均较治疗前升高,且观察组高于对照组(均P<0.05)。治疗后2组体重指数较治疗前升高,且观察组高于对照组,心率、丙氨酸转氨酶、天冬氨酸转氨酶水平均较治疗前降低,且观察组均低于对照组,差异均有统计学意义(均P<0.05)。观察组与对照组不良反应发生率比较[10.0%(4/40)比12.5%(5/40)],差异无统计学意义(P=0.157)。结论甲巯咪唑联合复方倍他米松可有效改善甲状腺功能亢进症患者甲状腺功能、肝功能,且不会增加不良反应的发生。

Objective To investigate the efficacy and safety of thiamazole combined with compound betamethasone on the treatment of hyperthyroidism.Methods From August 2018 to February 2020,80 patients with hyperthyroidism admitted to Department of Endocrinology,the Second Affiliated Hospital of Naval Medical University were enrolled.Patients were randomly divided into control group and observation group,with 40 cases in each group.The control group was treated with thiamazole tablets orally,and the observation group was treated with compound betamethasone injection for local injection at bilateral thyroid gland based on the control group.Both groups were treated for 3 months.The clinical efficacy,thyroid hormone and related antibody levels were compared between the two groups,and the incidence of adverse reactions during the treatment was recorded.Results The total effective rate in observation group was higher than that in control group and the difference was statistically significant(P<0.001).After treatment,serum levels of triiodothyronine,thyroxine,free triiodothyronine,free thyroxine,thyrotropin receptor antibody and thyroglobulin antibody in both groups were lower than those before treatment,and those in observation were lower than those in control group[(1.58±0.15)μg/L vs(1.93±0.19)μg/L,(97±10)μg/L vs(117±14)μg/L,(6.5±0.4)pmol/L vs(9.7±0.6)pmol/L,(21.0±0.5)pmol/L vs(26.6±0.6)pmol/L,(11.3±1.2)IU/L vs(24.0±2.2)IU/L,(36±5)IU/L vs(42±6)IU/L](all P<0.05).After treatment,the level of thyroid stimulating hormone in both groups was higher than that before treatment,and that in observation group was higher than that in control group(all P<0.05).After treatment,body mass index in both groups was higher than that before treatment,and that in observation group was higher than that in control group;heart rate,alanine aminotransferase and aspartate aminotransferase levels in both groups were lower than those before treatment,and those in observation group were lower than those in control group(all P<0.05).There was no significant difference in the incidence of adverse reactions between observation group and control group[10.0%(4/40)vs 12.5%(5/40)](P=0.157).Conclusion Thiamazole combined with compound betamethasone can effectively improve thyroid function and liver function in patients with hyperthyroidism and will not increase the occurrence of adverse reactions.