倍他米松联合丙硫氧嘧啶治疗难治性甲亢患者的效果

Effects of Betamethasone combined with Propylthiouracil treatment of patients with refractory hyperthyroidism

目的:探讨倍他米松联合丙硫氧嘧啶治疗难治性甲状腺功能亢进症(甲亢)患者的效果。方法:选取2019年3月至2021年2月该院收治的86例难治性甲亢患者进行前瞻性研究,按照随机数字表法分为观察组和对照组各43例。两组均予以基础治疗,在此基础上,对照组采用丙硫氧嘧啶治疗,观察组在对照组基础上联合倍他米松治疗,两组均连续治疗14 d。比较两组疗效、治疗前后血清甲状腺激素[游离三碘甲腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺激素(TSH)]水平、肝功能指标[丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)]水平及不良反应发生率。结果:观察组治疗总有效率为93.02%(40/43),高于对照组的69.77%(30/43),差异有统计学意义(P<0.05);观察组治疗后FT_(3)、FT_(4)、ALT、AST水平均低于对照组,TSH水平高于对照组,差异有统计学意义(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:倍他米松联合丙硫氧嘧啶治疗难治性甲亢患者可提高治疗总有效率,改善甲状腺激素水平,保护肝功能,且安全性良好。

Objective:To explore effects of Betamethasone combined with Propylthiouracil treatment of patients with refractory hyperthyroidism.Methods:A prospective study was conducted on 86 patients with refractory hyperthyroidism admitted to the hospital from March 2019 to February 2021.They were divided into observation group and control group according to the random number table method,43 cases in each.Both groups were given basic treatment.On this basis,the control group was treated with Propylthiouracil,while the observation group was treated with Betamethasone on the basis of that of the control group.Both groups were treated for 14 d.The efficacy,the serum thyroid hormone levels[free triiodothyronine(FT3),free thyroxine(FT4),thyroid stimulating hormone(TSH)]before and after the treatment,the liver function index levels[alanine aminotransferase(ALT),aspartate aminotransferase(AST)],and the incidence of adverse reactions were compared between the two groups.Results:The total effective rate of treatment in the observation group was 93.02%(40/43),which was higher than 69.77%(30/43)in the control group,and the difference was statistically significant(P<0.05).After the treatment,the levels of FT_(3),FT_(4),ALT and AST in the observation group were lower than those in the control group,the TSH level was higher than that in the control group,and the differences were statistically significant(P<0.05).However,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions:Betamethasone combined with Propylthiouracil in the treatment of the refractory hyperthyroidism patients can improve the total effective rate of treatment,improve the thyroid hormone levels,protect the liver function,and have good safety.