[关键词]
[摘要]
目的探讨甲巯咪唑和丙硫氧嘧啶对甲状腺功能亢进患者肝功能影响的疗效。方法选取80例甲状腺功能亢进患者,随机分为两组,甲组(41例)口服甲巯咪唑,乙组(39例)口服丙硫氧嘧啶片。观察并记录两组患者治疗前后甲状腺功能指标,肝功能指标,肝功能受损情况及治疗期间不良反应情况,评价甲巯咪唑和丙硫氧嘧啶对甲状腺功能亢进患者肝功能的影响。结果治疗前,两组患者由于甲状腺功能亢进,三碘甲腺原氨酸(FT3)、四碘甲腺原氨酸(FT4)均处于高水平状态,且差异无统计学意义。促甲状腺激素(TSH)分泌受到抑制,处于较低水平。治疗后,患者甲状腺功能亢进症状有所改善,患者FT3、FT4较治疗前降低,TSH较治疗前升高(P<0.05),但组间比较差异无统计学意义。治疗前,两组丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、谷氨酰转肽酶(GGT)水平相比,差异无统计学意义。治疗后乙组ALT、AST、GGT水平均有所升高,并明显高于甲组(P<0.05),其中,以ALT变化最为明显;甲组治疗前后无明显变化。治疗期间,甲组患者出血5例肝损伤,乙组14例肝损伤,乙组患者肝损伤比例明显高于甲组(P<0.05),乙组患者肝脏损伤发生时间明显晚于甲组(P<0.05)。治疗期间,两组不良反应发生率无统计学差异。结论甲巯咪唑与丙硫氧嘧啶对甲状腺功能亢进的疗效相当。与丙硫氧嘧啶相比,甲巯咪唑对肝脏损伤程度较小,但服药后较早引起肝脏损伤,建议在甲状腺功能亢进治疗期间,应定期复查患者肝功能。
[Key word]
[Abstract]
Objective To compare methimazole and propylthiouracil affecting liver function by treating hyperthyroidism. Methods Total 80 patients with hyperthyroidism were randomly divided into two groups. Group A (41 cases) was given methimazole, group B (39 cases) was given propylthiouracil. The effect of methimazole and propylthiouracil affecting liver function by treating hyperthyroidism was evaluated by the indexes of thyroid function, liver function, liver damage, and adverse reaction during treatment. Results Before treatment, there were no statistical significance on FT3 and FT4 between two groups. After treatment, the FT3and FT4 were decreased and TSH was increased in two groups (P < 0.05). But there were no statistical significance between two groups. Before treatment, there was no statistical significance on ALT, AST, and GGT between two groups. After treatment, the ALT, AST, and GGT increased in group B and higher than that of group A (P < 0.05). The ALT, AST, and GGT had no change before and after treatment in the group A. During treatment, there were five cases of liver injury in group A and 14 cases in group B. The liver injury rate of group B was higher than that of group A (P < 0.05) and injury time of group B was later than that of group A. During treatment, there was no statistical significance on adverse reaction rate between two groups. Conclusion The efficacy of methimazole was equal to propylthiouracil in treating hyperthyroidism. Compared with propylthiouracil, the methimazole had less injury on liver but induce the liver injury in earlier. It is suggested that the patients should check the liver function regularly during treatment.
[中图分类号]
[基金项目]