丙硫氧嘧啶联合比索洛尔治疗甲亢合并房颤的效果探讨

Efficacy of propylthiouracil combined with bisoprolol in treating hyperthyroidism with atrial fibrillation

目的:探讨甲亢合并房颤患者应用丙硫氧嘧啶联合比索洛尔治疗的临床效果。方法:将我院2020年1月至2022年1月期间收治的100例甲亢合并房颤患者,随机分为对照组或观察组。对照组49例患者采用丙硫氧嘧啶进行治疗;观察组51例在对照组治疗方案上联合比索洛尔治疗。分析对比两组的临床疗效,甲状腺功能、血清尿酸以及心脏功能、窦性心律转复情况以及药物导致的不良事件。结果:治疗3m后,观察组总有效率明显高于对照组(P<0.05)。两组血清游离三碘甲状腺原氨酸(Free triiodothyronine,FT3)、游离甲状腺素(Free thyroxine,FT4)、血尿酸(Uric acid,UA)以及心率(Heart rate,HR)水平较治疗前均显著降低,且观察组明显低于对照组(P<0.05)。两组促甲状腺激素(Thyroid-stimulating hormone,TSH)以及高峰射血率(Peak ejection fraction,PER)、左室射血分数(Left ventricular ejection fraction,LVEF)水平较治疗前显著升高,且观察组明显高于对照组(P<0.05)。观察组患者窦性心律转复率较对照组显著更高(P<0.05)。两组不良事件情况差异不显著。结论:比索洛尔联合丙硫氧嘧啶治疗甲亢合并房颤能改善患者甲状腺功能和心脏功能,促进窦性心律转复,且安全性佳。

Objective:To explore the clinical effects of propylthiouracil combined with bisoprolol in the treatment of patients with hyperthyroidism complicated with atrial fibrillation.Methods:100 patients with hyperthyroidism and atrial fibrillation treated in the hospital from January 2020 to January 2022 were randomly classified into control group and observation group.49 patients in control group were treated with propylthiouracil,and the other 51 patients in observation group were combined with bisoprolol in addition to the control group.The clinical efficacy,thyroid function,serum uric acid,cardiac function,sinus rhythm conversion and drug-induced adverse events in the two groups were analyzed and compared.Results:After 1 month of treatment,the total effective rate in observation group was obviously higher than that in control group(P<0.05).The levels of serum free triiodothyronine(FT3),free thyroxine(FT4),blood uric acid(UA)and heart rate(HR)in both groups were significantly decreased compared with those before treatment,and the levels in observation group were obviously lower than those in control group(P<0.05).The levels of thyroid-stimulating hormone(TSH),peak ejection rate(PER)and left ventricular ejection fraction(LVEF)in the two groups were significantly enhanced compared to those before treatment,and the levels in observation group were obviously higher than those in control group(P<0.05).The conversion rate of sinus rhythm in observation group was significantly higher compared to control group(P<0.05).There were no significant differences in adverse events between the two groups.Conclusion:Bisoprolol combined with propylthiouracil in the treatment of patients with hyperthyroidism and atrial fibrillation can improve the thyroid function and cardiac function,and promote the sinus rhythm conversion,with good safety.