甲巯咪唑联合比索洛尔对甲状腺功能亢进患者甲状腺功能、糖脂代谢及血清皮质醇、促肾上腺皮质激素、β_(2)-微球蛋白的影响

Influence of Methimazole Combined with Bisoprolol on Thyroid Function,Glucose and Lipid Metabolism,Serum Cortisol,Adrenocorticotropic Hormone and β_(2)-microglobulin in Patients with Hyperthyroidism

目的:探讨甲巯咪唑联合比索洛尔对甲状腺功能亢进患者甲状腺功能、糖脂代谢及血清皮质醇(Cor)、促肾上腺皮质激素(ACTH)、β_(2)-微球蛋白(β_(2)-MG)的影响。方法:选择2019年1月-2021年1月沈阳市第一人民医院收治的100例甲状腺功能亢进患者,采用随机数字表法将其分为观察组及对照组,各50例。在甲巯咪唑治疗基础上,观察组另给予比索洛尔治疗,而对照组另给予普萘洛尔治疗。记录比较两组治疗前后促甲状腺激素(TSH)、总甲状腺素(TT_(4))、总三碘甲状腺原氨酸(TT_(3))、游离T_(4)(FT_(4))、游离T_(3)(FT_(3))、空腹血糖(FPG)、餐后2 h血糖(2 h PG)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、Cor、ACTH及β_(2)-MG;统计比较两组不良反应发生情况。结果:两组治疗前各指标比较,差异均无统计学意义(P>0.05);治疗后,两组TSH、TC、TG、LDL-C、Cor及ACTH均高于治疗前(P<0.05),TT_(4)、TT_(3)、FT_(4)、FT_(3)、FPG、2 h PG及β_(2)-MG均低于治疗前(P<0.05),观察组TC、TG、LDL-C均低于对照组(P<0.05),两组间TSH、TT_(4)、TT_(3)、FT_(4)、FT_(3)、FPG、2 h PG、Cor、ACTH及β_(2)-MG比较,差异均无统计学意义(P>0.05)。观察组不良反应发生率略低于对照组,但差异无统计学意义(P>0.05)。结论:甲巯咪唑联合比索洛尔治疗甲状腺功能亢进可有效改善甲状腺功能、糖脂代谢、肾上腺皮质功能及β_(2)-MG,与甲巯咪唑联合普萘洛尔相比,对脂代谢影响较小。

Objective:To investigate the influence of Methimazole combined with Bisoprolol on thyroid function,glucose and lipid metabolism,serum cortisol (Cor),adrenocorticotropic hormone (ACTH) and β_(2)-microglobulin (β_(2)-MG) in patients with hyperthyroidism.Method:A total of 100 patients with hyperthyroidism in the First People’s Hospital of Shenyang from January 2019 to January 2021 were selected,and they were randomly divided into observation group and control group,with 50 cases in each group.On the basis of Methimazole treatment,the observation group was treated with Bisoprolol,while the control group was treated with Propranolol.Thyroid stimulating hormone (TSH),total thyroxine (TT_(4)),total triiodothyronine (TT_(3)),free T_(4) (FT_(4)),free T_(3) (FT_(3)),fasting blood glucose (FPG),2 h postprandial blood glucose (2 h PG),total cholesterol (TC),triglyceride (TG),low-density lipoprotein cholesterol (LDL-C),Cor,ACTH and β_(2)-MG were recorded and compared between the two groups before and after treatment.The incidence of adverse reactions was compared between the two groups.Result:There were no significant differences in various indicators between the two groups before treatment (P>0.05);after treatment,TSH,TC,TG,LDL-C,Cor and ACTH in the two groups were higher than those before treatment (P<0.05),while TT_(4),TT_(3),FT_(4),FT_(3),FPG,2 h PG and β_(2)-MG in the two groups were lower than those before treatment (P<0.05);TC,TG and LDL-C in the observation group were lower than those in the control group (P<0.05),there were no significant differences in TSH,TT_(4),TT_(3),FT_(4),FT_(3),FPG,2 h PG,Cor,ACTH andβ_(2)-MG between the two groups (P>0.05).The incidence of adverse reactions in the observation group was slightly lower than that in the control group,but the difference was not statistically significant (P>0.05).Conclusion:Methimazole combined with Bisoprolol in the treatment of hyperthyroidism can effectively improve thyroid function,glucose and lipid metabolism,adrenocortical function and β_(2)-MG,compared with Methimazole combined with Propranolol,it has less influence on lipid metabolism.