甲巯咪唑和丙硫氧嘧啶治疗甲状腺功能亢进症致肝功能异常的临床研究

Study on liver dysfunction induced by methimazole and propylthiouracil for the treatment of hyperthyroidism

甲巯咪唑(methimazole,MMI)和丙硫氧嘧啶(propylthiouracil,PTU)是临床上仅有的抗甲状腺药物,疗效确切,但不良反应发生率较高。美国食品药品监督管理局(FoodandDrugAdministration,FDA)警告PTU可引发致命的爆发性肝细胞坏死,但另有研究证据表明在造成急性肝细胞损伤的概率上MMI与PTU同样常见。本文报道6631例患者在消除人口学特征、初始日剂量及合并用药等混杂因素的情况下,MMI组发生肝损伤的比例和PTU组相比差异无统计学意义(P=0.762),并分析了两药致肝功能异常的影响因素。

Methimazole(MMI)and propylthiouracil(PTU)are the only clinical antithyroid drugs,with definite efficacy,but a high incidence of adverse reactions.The Food and Drug Administration(FDA)warns that PTU can cause fatal explosive hepatocyte necrosis,but other research evidence has shown that MMI is as common as PTU in causing acute hepatocyte damage.In this study,we reported that in 6631 patients,after eliminating con-founding factors such as demographic characteristics,initial daily dose and combined medication,there was no sta-tistically significant difference in the proportion of liver injury between the MMI group and the PTU group(P-0.762),the influencing factors causing abnormal liver function by two drugs were also analyzed.