Clinical effect of methimazole combined with levothyroxine in the treatment of Graves disease
10.3760/cma.j.issn.1008-6706.2020.19.003
- VernacularTitle:甲巯咪唑联合左甲状腺素治疗毒性弥漫性甲状腺肿的临床效果分析
- Author:
Jian OUYANG
1
;
Lian LIU
;
Jianbin CHEN
;
Ying LIU
Author Information
1. 解放军联勤保障部队第九〇三医院内分泌科，杭州 310004
- From:
Chinese Journal of Primary Medicine and Pharmacy
2020;27(19):2315-2318
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the efficacy and safety of methimazole combined with levothyroxine in the treatment of patients with Graves disease (GD), and provide theoretical basis for clinical practice.Methods:Sixty-eight patients with confirmed GD who admitted to the 903rd Hospital of PLA from January 2013 to January 2018 were selected and divided into control group and observation group by random number table method.The control group was given propylthiouracil combined with levothyroxine.The observation group was treated with methimazole and levothyroxine.The clinical features of hyperthyroidism, changes in hormone levels, and bone metabolism were compared between the two groups before and after treatment.Results:After treatment, the incidence of exophthalmos, goiter and thyrotropin receptor antibody (TRAb) positive rate were significantly reduced in the two groups (the control group changed from 10 cases to 2 cases, and the observation group changed from 10 cases to 0 case), the differences were statistically significant (χ 2=27.1, 16.2, all P<0.05). The differences in TSH, FT 3, and FT 4 before and after treatment were statistically significant [the control group: TSH changed from (0.02±0.02)mU/L to (3.01±0.94)mU/L, FT 3 from (16.92±2.25)pmol/L to (10.29±1.68)pmol/L, FT 4 from (52.61±10.22)pmol/L to (19.82±4.11)pmol/L; the observation group: TSH from (0.02±0.01)mU/L to (1.97±1.27)mU/L, FT 3 from (17.09±2.72)pmol/L to (3.95±0.84)pmol/L, and FT 4 from (53.82±10.11)pmol/L to (12.65±3.31)pmol/L], and the improvement of TSH, FT 3 and FT 4 in the observation group were better than those in the control group ( t=3.24, 9.51, 16.31, all P<0.05). After treatment, the levels of PTH, CT, blood calcium, blood phosphorus were increased [the control group: PTH changed from (38.32±11.41)ng/L to (42.83±14.22)ng/L, CT changed from (8.66±2.22)ng/mL to (8.01±4.55)ng/mL, blood calcium level changed from (2.01±0.12)pmol/L to (2.53±0.20)pmol/L, blood phosphorus level changed from (1.12±0.08)pmol/L to (1.37±0.09)pmol/L; the observation group: PTH changed from (38.31±12.52)ng/L to (46.33±15.03)ng/L, CT changed from (8.45±2.21)ng/mL to (11.49±7.33)ng/mL, the calcium level changed from (2.02±0.98)pmol/L to (2.82±0.87)pmol/L, the blood phosphorus level changed from (1.10±0.07)pmol/L to (1.42±0.16)pmol/L]. The improvement of PTH and CT in the observation group was better than those in the control group ( t=6.51, 7.31, all P<0.05). Conclusion:Methimazole combined with levothyroxine in the treatment of GD has good therapeutic effect on the clinical characteristics of hyperthyroidism, changes in hormone levels, and bone metabolism.The clinical efficacy is reliable and there are few adverse reactions, which deserves clinical reference.
