甲巯咪唑乳膏治疗甲状腺功能亢进症并发肝衰竭患者2例报告及文献复习

目的：探讨甲巯咪唑乳膏局部外用治疗甲状腺功能亢进症（甲亢）并发肝衰竭患者的疗效，为该病的临床治疗提供参考。方法：本组2例患者均以黄疸为主要临床表现入院，肝功能及凝血功能指标均支持肝衰竭诊断，甲状腺功能检测指标提示甲亢，结合其他相关检查结果均诊断为甲亢并发肝功能衰竭和乙型病毒性肝炎，均给予甲巯咪唑乳膏外用及相关治疗。结果：2例患者经治疗后复查肝功能均恢复至正常，甲状腺功能明显好转，随访至今，现1例患者已将甲巯咪唑乳膏外用改为口服甲巯咪唑，另1例患者现仍继续外用甲巯咪唑乳膏进行治疗。结论：甲亢并发肝功能衰竭在治疗上存在冲突，甲巯咪唑乳膏局部外用的方式在减少药物致肝损害风险的同时在治疗甲亢方面也有较好的疗效，该方法为甲亢并发肝衰竭患者的临床治疗提供了新思路。

Treatment of patients with hyperthyroidism complicated with liver failure with methimazole cream:A report of 2 cases and literature review

Objective: To investigate the efficacy of local application of methimazole cream in the patients with hyperthyroidism complicated with liver failure, and to provide reference for its clinical treatment.Methods: Two patients were admitted to hospital with jaundice as the main performance. Liver function and coagulation function supported the diagnosis of liver failure. The thyroid function indicators suggested hyperthyroidism. Combined with other related examination results, liver failure, hyperthyroidism and hepatitis B virus were diagnosed,and the local treatment of methimazole cream and other related treatments were given.Results: After treatment, the liver function of two patients returned to normal and the thyroid function was improved. After follow-up, one patient changed the external use of methimazole cream to oral treatment,and another patient was still treated in a local manner.Conclusion: There is a conflict in the treatment of hyperthyroidism complicated with liver failure. The local application of methimazole cream in the topic of reducing the risk of liver damage caused by drugs has good results in the treatment of hyperthyroidism. This method also provides the new ideas for its clinical treatment.