左甲状腺素钠联合甲巯咪唑治疗年龄>60岁弥漫性毒性甲状腺肿患者的疗效评价

Efficacy evaluation of Levothyroxine sodium and Methimazole in treatment of patients with Graves disease over 60 years old

目的分析左甲状腺素钠联合甲巯咪唑治疗弥漫性毒性甲状腺肿(Graves病)的效果。方法选取2016年1月至2020年8月我院103例Graves病患者(年龄>60岁),随机抽签法分组,单药治疗组51例以甲巯咪唑治疗,联合治疗组52例以甲巯咪唑联合左甲状腺素钠治疗。比较2组疗效、不良反应发生率及治疗前后Spitzer生活质量指数(SQOL)评分、血清促甲状腺激素(TSH)、游离四碘甲状腺原氨酸(FT4)、游离三碘甲状腺原氨酸(FT3)水平变化。结果2组总有效率对比,联合治疗组96%高于单药治疗组82%(P<0.05);与单药治疗组比较,联合治疗组治疗后FT4、FT3水平较低,TSH水平及SQOL评分较高(P<0.05);另外2组不良反应发生率比较差异无统计学意义(P>0.05)。结论左甲状腺素钠联合甲巯咪唑对Graves病(年龄>60岁)疗效显著,能有效改善甲状腺功能,提高生活质量,且用药安全性较高。

Objective To determine the effect of Levothyroxine sodium and Methimazole in the treatment of Graves disease.Methods A total of 103 patients with Graves disease(age>60 years old)admitted to our hospital between January 2016 and August 2020 were prospectively included and randomly divided into groups.The monotherapy group were treated with Methimazole(n=51),and the combined treatment group were treated with Methimazole+Levothyroxine sodium(n=52).The efficacy,incidence of adverse reactions,Spitzer quality of life index(SQOL)scores,and levels of serum thyroid stimulating hormone(TSH),free tetraiodothyronine(FT4)and free triiodothyronine(FT3)at baseline and after the treatment were compared between the two groups.Results The total effective rate in the combined treatment group was higher than that in the monotherapy group(96%vs 82%,P<0.05).Compared with the monotherapy group,the FT4 and FT3 levels after treatment were lower in the combined treatment group,whereas the TSH level and SQOL scores were higher(all P<0.05).There was no significant difference in the incidence of adverse reactions between the other two groups(P>0.05).Conclusion Levothyroxine sodium+Methimazole is significantly effective in the treatment of Graves disease(age>60 years old).It may effectively improve thyroid function and promote quality of life with high safety.