丙硫氧嘧啶与甲巯咪唑对甲状腺功能亢进症肝功能影响情况的对比研究

目的探究并分析甲巯咪唑与丙硫氧嘧啶对甲状腺功能亢进症患者肝功能的影响。方法选取温岭市第四人民医院内科2010年1月~2013年1月106例甲状腺功能亢进症患者为研究对象,应用随机数字表法将甲状腺功能亢进症患者分为A组和B组,甲巯咪唑初始剂量为30 mg/d,丙硫氧嘧啶300 mg/d,根据患者病情逐渐减至甲巯咪唑5~10 mg/d,丙硫氧嘧啶50~100 mg/d进行治疗,维持2年时间,比较治疗后两组患者肝功能各项指标变化情况。结果 B组患者肝损伤发生率为26.42%,明显高于A组(11.32%),差异有统计学意义(P<0.05)。但是,A组患者肝损伤发生时间为(18.74±7.68)d,明显早于B组(41.65±8.27)d],差异有统计学意义(P<0.05),丙硫氧嘧啶所致肝损伤以血清谷丙转氨酶升高为主,占78.57%,甲巯咪唑所致肝损伤以胆红素升高为主,占66.67%,两组患者肝功能指标呈现不同特点,B组患者与A组患者肝功能损伤程度方面差异无统计学意义(P>0.05)。结论甲巯咪唑较丙硫氧嘧啶更易出现肝损伤,但是,甲巯咪唑出现肝损伤时间稍早于丙硫氧嘧啶;丙硫氧嘧啶和甲巯咪唑所致肝损伤多数为轻度性肝损伤,丙硫氧嘧啶所致肝损伤以血清谷丙转氨酶的升高,甲巯咪唑所致肝损伤以胆红素升高为主。

Contrastive study on the effect of Propylthiouracil and Methimazole to liver function in hyperthyroidism patients

Objective To study the effect of Propylthiouracil and Methimazole to liver function in hyperthyroidism pa-tients.Methods 106 patients with hyperthyroidism who were admitted to Department of Internal Medicine of the FourthPeople＇s Hospital of Wenling City from January 2010 to January 2013 were divided into group A and B by randomnumber table.The initial dose of Methimazole was 30 mg/d,and the initial dose of Propylthiouracil was 300 mg/d.Thedose of Methimazole and Propylthiouracil was reduced to 5-10 mg/d and 50-100 mg/d according to patient＇s conditionrespectively.The time of treatment was two years,the changes of liver function after treatment were compared betweenthe two groups.Results The incidence rate of liver injury in group B （26.42％） was significantly higher than that ingroup A （11.32％） （P ＜ 0.05）,but the happiness time of liver injury in group A （18.74±7.68） d] was significantly moreearlier than that in group B （41.65±8.27） d （P ＜ 0.05）.The main manifestation of liver injury by Propylthiouracil wasthe increasing of serum alanine aminotransferase （78.57％）,while the main manifestation of liver injury by Methimazolewas the increasing of bilirubin （66.67％）,which showed the different characters of indexes in liver injury.But there wasno significant difference of liver injury between the two groups （P ＞ 0.05）.Conclusion The liver injury by Methimazolehappens more easily than that by Propylthiouracil,but the time of liver injury by Methimazole is little earlier than thatby Propylthiouracil.The liver injury by Methimazole and Propylthiouracil is almost mild,the main manifestation of liverinjury by Propylthiouracil is the increasing of serum alanine aminotransferase and the main manifestation of liver injuryby Methimazole is the increasing of bilirubin.