甲巯咪唑治疗甲状腺功能亢进症的效果及对肝功能的影响

Effect of methimazole on hyperthyroidism and its influence on liver function

目的以治疗甲状腺功能亢进症的需求为重点,探讨采用巯咪唑(MMI)治疗的临床效果及其对肝功能的影响。方法选取东莞市塘厦医院2014年8月—2017年3月收治的94例甲状腺功能亢进症患者,随机分为观察组和对照组,每组47例,两组分别给予甲巯咪唑和丙硫氧嘧啶口服治疗,连续用药12个月,评价治疗前后两组患者游离三碘甲腺原氨酸(FT3)、游离四碘甲腺原氨酸(FT4)、总三碘甲腺原氨酸(TT3)及总四碘甲腺原氨酸(TT4)水平,并通过随访总胆红素(TBiL)、丙氨酸氨基转移酶(ALT)、天冬氨酸转氨酶(AST)、碱性磷酸酶(ALP)水平观察肝功能的变化情况。结果治疗前两组FT3、FT4、TT3及TT4比较无统计学差异(P>0.05);治疗后,两组FT3、FT4、TT3及TT4均较治疗前明显降低(P<0.05),且观察组均低于对照组,差异有统计学意义(P<0.05)。治疗前,两组患者TBiL、ALT、AST、ALP等肝功能指标比较差异无统计学意义(P>0.05);治疗后,两组TBiL、ALT、AST、ALP水平均较治疗前升高,但观察组肝功能指标低于对照组,差异有统计学意义(P<0.05)。两组不良反应发生率比较差异无统计学意义(P>0.05)。结论甲巯咪唑治疗甲状腺功能亢进症效果显著,可降低甲状腺激素水平,对肝功能影响较小。

Objective To evaluate the clinical effect of methimazole on patients with hyperthyroidism and liver function for the treatment of hyperthyroidism. Methods A total of 94 patients with hyperthyroidism treated in Tangxia Hospital during August 2014 to March 2017 were randomly divided into observation group and control group(n=47). The observation group and control group were given methimazole and propylthiouracil oral treatment for 12 months, respectively. The indexes such as free thyroxine 3(FT3), free thyroxine 4(FT4), total thyroxine 3(TT3) and total thyroxine 4(TT4)levels were compared before and after the treatment. Liver function represented by total bilirubin(TBiL), glutamic-oxaloacetic transaminase(ALT), alanine aminotransferase(AST), alkaline phosphatase(ALP) levels was observed. Results The indexes such as FT3, FT4, TT3 and TT4 levels were not significantly different between the two groups before treatment(all P>0.05), but which were significantly lower after treatment(P<0.05),especially in the observation group(all P<0.05).There was no statistically significant difference in TBiL, ALT, AST, ALP levels in the two groups(all P<0.05). After treatment, the levels of TBiL, ALT, AST and ALP in both groups were higher than those before treatment, and the aboved liver function indexes in the observation group were lower than those in the control group, and the differences were statistically significant(all P<0.05).Conclusion Methimazole is effective in the treatment of hyperthyroidism, which can reduce thyroid hormone level and have less effect on liver function.