左甲状腺素、甲巯咪唑联合治疗老年弥漫性甲状腺肿伴甲状腺功能亢进的疗效分析

Efficacy analysis of levothyroxine combined with methimazole in the treatment of diffuse goiter with hyperthyroidism in the elderly

目的分析对于老年弥漫性甲状腺肿伴甲状腺功能亢进(甲亢)患者联合应用左甲状腺素以及甲巯咪唑治疗的效果。方法70例老年弥漫性甲状腺肿伴甲亢患者,借助随机数字表法分为对照组、观察组,每组35例。对照组以甲巯咪唑治疗,观察组联合应用甲巯咪唑、左甲状腺素治疗。对比两组患者的临床疗效、甲状腺体积、血清甲状腺激素[游离三碘甲腺原氨酸(FT3)、游离甲状腺素(FT4)以及促甲状腺激素(TSH)]水平、炎症因子[血清白细胞介素-2(IL-2)以及转化生长因子-β(TGF-β)]水平以及用药不良反应发生率。结果观察组治疗总有效率97.14%高于对照组的82.86%(P<0.05)。治疗后,两组的甲状腺体积均小于治疗前,且观察组甲状腺体积(11.16±6.95)ml小于对照组的(14.75±6.19)ml(P<0.05)。两组药物不良反应发生率对比差异微小(χ2=0.215,P=0.643>0.05)。治疗后,观察组血清FT3(4.12±0.65)pmol/L、FT4(11.16±1.75)pmol/L均低于对照组的(6.13±1.19)、(16.95±3.25)pmol/L,TSH(3.75±0.69)mU/L高于对照组的(2.13±0.62)mU/L(P<0.05)。治疗后,与对照组相比,血清IL-2、TGF-β水平均为观察组更低(P<0.05)。结论老年弥漫性甲状腺肿伴甲亢患者联合应用左甲状腺素以及甲巯咪唑治疗的效果确切,且安全性佳。

Objective To analyze the effect of levothyroxine combined with methimazole in the treatment of diffuse goiter with hyperthyroidism in the elderly.Methods 70 elderly patients with diffuse goiter and hyperthyroidism were grouped into the control group and the observation group by random number table method,both 35 cases.The control group was treated with methimazole,and the observation group was treated with methimazole and levothyroxine.Both groups were compared in terms of clinical efficacy,thyroid volume,serum thyroid hormone[free triiodothyronine(FT3),free thyroxine(FT4),and thyroid stimulating hormone(TSH)]level,inflammatory factors[serum interleukin-2(IL-2)and transforming growth factor-β(TGF-β)]level,and incidence of adverse drug reactions.Results The total effective rate of 97.14%in the observation group was higher than 82.86%in the control group(P<0.05).After treatment,the thyroid volume in both groups was smaller than that before treatment,and the thyroid volume of(11.16±6.95)ml in the observation group was smaller than(14.75±6.19)ml in the control group(P<0.05).There was little difference in the incidence of adverse drug reactions between the two groups(χ2=0.215,P=0.643>0.05).After treatment,the observation group had serum FT3 of(4.12±0.65)pmol/L and FT4 of(11.16±1.75)pmol/L,which were lower than(6.13±1.19)and(16.95±3.25)pmol/L in the control group;TSH of(3.75±0.69)mU/L in the observation group was higher than(2.13±0.62)mU/L in the control group(P<0.05).After treatment,the serum levels of IL-2 and TGF-βin the observation group were lower than those in the control group(P<0.05).Conclusion Combination of levothyroxine and methimazole is effective and safe for elderly patients with diffuse goiter and hyperthyroidism.