丙基硫氧嘧啶改善甲亢患者心脏及内分泌功能的疗效及意义

１３例初诊甲亢患者于应用丙基硫氧嘧啶治疗前、治疗３个月及６个月时超声心动图检测心功能并用放射免疫分析法检测血浆心钠素（ＡＮＰ）、肾素活性（ＰＲＡ）、血管紧张素Ⅱ（ＡｎｇⅡ）及血清甲状腺激素（ＴＴ＿３、ＴＴ＿４）水平。治疗后心率下降（Ｐ＜０．００１），体重增加（Ｐ＜０．００１），心输出量及心指数下降（Ｐ＜０．０５）。各瓣膜区流速减慢（Ｐ＜０．０５），ＴＴ＿３、ＴＴ＿４恢复正常。随高动力性循环状态改善，血浆ＡＮＰ水平明显下降（Ｐ＜０．０１）．ＡｎｇⅡ及ＰＲＡ明显升高（Ｐ＜０．０１及０．００１）。提示丙基硫氧嘧啶能有效改善甲亢患者的心脏功能及内分泌功能。

Effects of Propylthiouracil on Improving Heart and Endocrine Functions in Patients with Hyperthyroidism and Its Clinical Significance

Thirteen patients with newly diagnosed hyperthyroidism were treated with propylthiouracil.Heart function and plasma atrial natriuretic peptide(ANP), plasma renin activity(PRA)and angiotension Ⅱ(Ang Ⅱ)levels of the patients were measured by echocardiography and specific radioimmunoassay, before treatment and during treatment at third month and sixth month. After treatment, heart rate of the patients were significantly decreased(P<0.001), body weight were increased(P<0.01), cardiac output,cardiac index,peak flow velocity of mitral valve, aortic valve and main pulmonary artery were decreased(P<0.05),thyroid hormone became normal. With hyperdynamic circulating state improving, plasma ANP level was significantly decreased(P<0.01)and Ang Ⅱ and PRA were increased(P<0. 01). These results suggest that propylthiouracil is an effective drug in improving heart and endocrine functions in patients with hyperthyroidism.