丙基硫氧嘧啶联合左甲状腺素钠片治疗良性多发甲状腺结节的临床价值

Clinical value of propylthiouracil combined with levothyroxine sodium tablets in the treatment of benign multiple thyroid nodules

目的:探讨丙基硫氧嘧啶联合左甲状腺素钠片治疗良性多发甲状腺结节的临床疗效及对患者预后的影响。方法:选取2018年8月至2022年8月期间于本院就诊的80例良性多发甲状腺结节患者,随机分为对照组、研究组,各40例。对照组口服左甲状腺素钠片25μg·次-1,1次·d-1;研究组在此基础上加用丙基硫氧嘧啶(初始剂量为150~400 mg·d-1,临床症状缓解后维持至50~100 mg·次-1,1次·d-1)治疗。治疗6 m后比较两组的临床疗效;并分别于治疗前、治疗6 m后采用放射免疫分析法检测游离甲状腺素(Free thyroxine,FT4)、游离三碘甲状腺原氨酸(Free triiodothyronine,FT3)、促甲状腺激素(Thyroid stimulating hormone,TSH)水平;采用GE Logiq E9型彩色多普勒超声诊断仪测量甲状腺结节直径、甲状腺体积;同时观察治疗期间不良反应。结果:研究组的治疗总有效率显著高于对照组(P<0.05)。研究组治疗后血清TSH水平低于对照组(P<0.05),但两组的FT3、FT4水平均无显著差异(P>0.05)。与对照组比较,研究组治疗后甲状腺结节直径、甲状腺体积较小(P<0.05)。两组不良反应无显著差异(P>0.05)。结论:丙基硫氧嘧啶联合左甲状腺素钠片治疗良性多发甲状腺结节,能提高治疗效果,改善促进甲状腺激素水平,抑制结节进展,改善预后。

Objective:To investigate the clinical efficacy and prognosis of propyl thiouracil combined with levothyroxine sodium tablets in the treatment of benign multiple thyroid nodules.Methods:Eighty patients with benign multiple thyroid nodules who were treated in our hospital from August 2018 to August 2022 were randomly divided into a control group and a study group,with 40 cases in each group.The control group was treated with levothyroxine sodium tablets(25μg·time-1,once·day-1);the study group was treated with propylthiouracil(initial dose of 150-400 mg·day-1,maintained at 50-100 mg·time-1,once·day-1)plus levothyroxine sodium tablets.After 6 months of treatment,the clinical efficacy of the two groups was compared.The free thyroxine(FT4),free triiodothyronine(FT3),and thyroid stimulating hormone(TSH)levels were measured using radioimmunoassay before and after treatment for 6 months.The thyroid nodule diameter and thyroid volume were measured using a GE Logiq E9 color Doppler ultrasound diagnostic instrument before and after treatment for 6 months.Adverse reactions during treatment were observed in two groups.Results:The total effective rate of the treatment group was significantly higher than that of the control group(P<0.05).The serum TSH level in the treatment group after treatment was lower than that in the control group(P<0.05),but there was no significant difference in the levels of FT3 and FT4 between the two groups(P>0.05).Compared with the control group,the diameter and volume of thyroid nodules in the treatment group after treatment were smaller(P<0.05).There was no significant difference in adverse reactions between the two groups(P>0.05).Conclusion:Propyl thiouracil combined with levothyroxine sodium tablets in the treatment of benign multiple thyroid nodules can improve the therapeutic effect,improve the thyroid hormone level,inhibit the progression of nodules,and improve the prognosis.