普萘洛尔联合甲巯咪唑对改善甲亢患者甲状腺功能及肝功能的影响

Effect of propranolol combined with methimazole on improving thyroid and liver function in patients with hyperthyroidism

摘要:

目的 分析普萘洛尔联合甲巯咪唑对改善甲状腺功能亢进（甲亢）患者甲状腺功能及肝功能的影响。方法 选取2021年1月至2022年12月郑州颐和医院内分泌科治疗的60例甲亢患者，按照数字随机分配法将其分为对照组（即甲巯咪唑，30例）和研究组（即普萘洛尔+甲巯咪唑，30例）。比较两组患者的用药效果。结果 两组患者经临床用药治疗10个月后，比较两组临床疗效发现，研究组治疗总有效率明显优于对照组（P<0.05）；治疗前两组游离三碘甲状腺原氨酸（FT3）、血清游离甲状腺素（FT4）和促甲状腺激素（TSH）指标比较均差异无统计学意义（P>0.05）；治疗10个月后，研究组FT3、FT4指标明显下降，TSH明显升高，且优于对照组（P<0.05）；两组治疗后肝功能［丙氨酸转氨酶（ALT）、天冬氨酸转氨酶（AST）和总胆红素（TBIL）］各指标水平均低于对照组（P<0.05）。结论 普萘洛尔联合甲巯咪唑相比单一的甲巯咪唑治疗甲亢患者，其效果更佳，能明显改善患者的甲状腺激素水平，还能减轻肝损伤，改善肝功能的各项指标，减少不良反应率，值得临床用药推广。

关键词:甲状腺功能亢进;普萘洛尔;甲巯咪唑;肝功能;临床疗效

Abstract:

Objective To analyze the effects of propranolol combined with methimazole on improving thyroid and liver function in patients with hyperthyroidism.Methods A total of 60 hyperthyroidism patients treated in Department of Endocrinology, Zhengzhou Yihe Hospital from January 2021 to December 2022 were selected and divided into control group (30 cases) and study group (30 cases) according to numerical random allocation method. The effect of medication was compared between the two groups.Results After 10 months of clinical treatment, the clinical efficacy of the two groups was compared and it was found that the total effective rate of the study group (propranolol+methimazole) was significantly better than that of the control group (methimazole), with statistical significance (P<0.05). There was no statistical significance in FT3, FT4 and TSH indexes between the two groups before treatment (P>0.05). However, after 10 months of clinical treatment, FT3 and FT4 indexes of patients in the study group were significantly decreased, and TSH was significantly increased, and was lower than that in the control group, with statistical significance (P<0.05). The indexes of liver function (ALT, AST and TBIL) in the two groups after treatment were statistically different (P<0.05).Conclusion Propranolol combined with methimazole is more effective than single methimazole in the treatment of hyperthyroidism patients, which can significantly improve the thyroid hormone level of patients, reduce liver injury, improve liver function indicators, and reduce adverse reaction rate, and is worthy of clinical promotion.

Key words:hyperthyroidism;propranolol;methimazole;liver function;clinical effect