普萘洛尔辅助丙硫氧嘧啶治疗老年甲状腺亢进的疗效及对糖脂代谢和ACTH水平的影响

Efficacy of Propranolol-assisted Propylthiouracil in the Treatment of Hyperthyroidism in the Elderly and Its Effect on Glucolipid Metabolism and ACTH Levels

目的探究普萘洛尔辅助丙硫氧嘧啶治疗老年甲状腺功能亢进(简称甲亢)的疗效及对糖脂代谢和促肾上腺皮质激素(adrenocorticotropic hormone,ACTH)水平的影响。方法方便选取2021年2月—2023年1月喀什地区第一人民医院收治的84例老年甲亢患者为研究对象,按抛硬币法随机分为两组,各42例。对照组使用丙硫氧嘧啶治疗,研究组在对照组基础上加用普萘洛尔,比较两组临床疗效。结果研究组治疗总有效率为95.24%,高于对照组的73.81%,差异有统计学意义(χ^(2)=7.372,P<0.05)。研究组总药物不良反应发生率低于对照组,差异有统计学意义(P<0.05)。治疗后,两组平均动脉压、心率、空腹血糖、总胆固醇、促肾上腺皮质激素及甲状腺激素均下降,且研究组各指标水平明显低于对照组,差异有统计学意义(P<0.05)。结论普萘洛尔联合丙硫氧嘧啶治疗老年甲状腺亢进,可改善其心功能和甲状腺功能,平衡糖脂代谢,同时减少药物不良反应的发生风险。

Objective To investigate the efficacy of propranolol-adjuvanted propylthiouracil in the treatment of hyperthyroidism(later referred to as hyperthyroidism)in the elderly and its effects on glucolipid metabolism and adrenocorticotropic hormone(ACTH)levels.Methods 84 elderly patients with hyperthyroidism admitted to the First People′s Hospital of Kashgar from February 2021 to January 2023 were conveniently selected as the study subjects and were randomly divided into two groups using the coin toss method,with 42 patients in each group.The control group was treated with propylthiouracil,while the study group added propranolol to the control group,compared the clinical efficacy of the two groups.Results The total effective rate of the study group was 95.24%,which was higher than the control group′s 73.81%,the difference was statistically significant(χ^(2)=7.372,P<0.05).The total incidence of adverse drug reactions in the study group was lower than that in the control group,the difference was statistically significant(P<0.05).After treatment,MAP,HR,FPG,TC,ACTH,and T4 in both groups decreased,and the levels of various indicators in the study group were significantly lower than those in the control group,the difference was statistically significant(P<0.05).Conclusion Propranolol combined with propylthiouracil in the treatment of hyperthyroidism in the elderly improves their cardiac and thyroid functions and balances their glycolipid metabolism,while reducing the risk of adverse drug reactions.