目的 探讨碳酸锂联合甲巯咪唑治疗甲状腺功能亢进的临床疗效。方法 选取2014年2月—2015年2月延安大学附属医院收治的甲状腺功能亢进患者92例,随机分为对照组和治疗组,每组各46例。对照组口服甲巯咪唑片,10～15 mg/次,2次/d,患者病情得到控制后,逐渐减轻剂量至5～10 mg/d。治疗组在对照组治疗基础上口服碳酸锂片,0.50 g/d,病情控制后0.25 g/d。两组患者同时给予保肝治疗,白细胞减少患者结合升白细胞药物治疗。两组患者均连续治疗6个月。观察两组的临床疗效,同时比较治疗前后两组血清游离甲状腺素(FT₄)、游离三碘甲状腺原氨酸(FT₃)、总T₃(TT₃)、总T₄(TT₄)、促甲状腺素(TSH)的变化情况。结果 治疗后,对照组和治疗组的总有效率分别为71.74%、93.48%,两组总有效率比较差异具有统计学意义(P< 0.05)。两组患者TT₃、TT₄、FT₃、FT₄均显著降低,TSH显著升高,同组治疗前后差异具有统计学意义(P< 0.05),且治疗组这些观察指标的改善程度优于对照组,两组比较差异具有统计学意义(P< 0.05)。结论 碳酸锂联合甲巯咪唑治疗甲状腺功能亢进具有较好的临床疗效,可改善甲状腺功能相关激素水平,具有一定的临床推广应用价值。

Objective To observe the clinical efficacy of lithium carbonate combined with thiamazole in treatment of thyroid function hyperfunction. Methods Patients (92 cases) with thyroid function hyperfunction in Yan'an University Affiliated Hospital from February 2014 to February 2015 were randomly divided into control and treatment groups, and each group had 46 cases. The patients in the control group were po administered with Thiamazole Tablets, 10—15 mg/time, twice daily. After the morbidity of patients was in remission, the dosage was gradually reduced to 5—10 mg/d. The patients in the treatment group were po administered with Lithium Carbonate Tablets on the basis of the control group, 0.50 g/d, and 0.25 g/d after disease was control. The patients in two groups were accepted the protect liver treatment, and patients with leucopenia were given drug therapy. The patients in two groups were treated for 6 months. After treatment, the efficacy was evaluated, and the changes of TT₃, TT₄, FT₃, FT₄, and TSH in two groups before and after treatment were compared. Results After treatment, the efficacies in the control and treatment groups were 71.74% and 93.48%, respectively, and there were differences between two groups (P < 0.05). After treatment, TT₃, TT₄, FT₃, and FT₄ were significantly decreased, TSH was significantly increased, and the difference was statistically significant in the same group (P < 0.05). These observed indexes in the treatment group were better than those in the control group, with significant difference between two groups (P < 0.05). Conclusion Lithium carbonate combined with thiamazole has curative effect in treatment of thyroid function hyperfunction, and can improve the levels of hormones related thyroid function, which has a certain clinical application value.