丙硫氧嘧啶联合氟羟强的松龙治疗自身免疫性甲状腺疾病伴甲亢70例临床研究

目的探讨丙硫氧嘧啶联合氟羟强的松龙在治疗自身免疫性甲状腺疾病（AITD）伴甲亢患者的临床疗效。方法将2010年5月～2012年8月收集的70例AITD伴甲亢患者随机分为两组：丙硫氧嘧啶治疗组和丙硫氧嘧啶联合氟羟强的松龙治疗组。每组35例。在治疗过程中，同时监测两组患者的血清促甲状腺激素（TSH）、血清游离甲状腺素（FT4）、血清游离三碘甲状腺原氨酸（FT3）、血清甲状腺过氧化物酶抗体（TPOAb）和甲状腺球蛋白抗体（TGAb）的变化水平，并分析其治疗效果。结果丙硫氧嘧啶治疗组治疗后FT4下降明显（P〈0．05），TSH的水平略有上升，TPOAb和TGAb与治疗前相比差异无显著性（P〉0．05）；丙硫氧嘧啶联合氟羟强的松龙治疗组治疗后FT3、FT4、TPOAb和TGAb较治疗前有下降明显，差异有统计学意义（P〈0．05），TSH较治疗前有显著性上升（P〈0．05）。结论丙硫氧嘧啶与氟羟强的松龙联合用药可以有效降低自身免疫性甲状腺疾病伴有甲亢患者血清中FT3、FT4、TPOAb和TGAb的水平，抑制病情的进一步发展，促进甲状腺功能的恢复。

Clinical study of propylthiouracil combined with triamcinolone for treatment of 70 cases with autoimmune thyroid disease accompanied with hyperthyroidism

Objective To determine the efficacy of propylthiouracil compbined with triamcinolone for treatment of AITD with hyperthyroidism. Methods Seventy cases of AITD with hyperthyroidism patients were randomly divided into propylthiouraeil treatment group and propylthiouracil combined with triamcinolone treatment group, each of 35 eases. The two groups were evaluated the levels of serum thyroid stimulating hormone （TSH）, serum free thyroxine （FT4）, serum free triiodothyronine （FT3）, serum thyroid peroxidase antibody （TPOAb） and thyroglobulin antibody （TGAb） before and after treatment. Results Propylthiouraeil treatment group, the levels of FT4 were lower than before treatment （P 〈 0.05）, the changes of TSH, TPOAb, TGAb had no significant difference （P 〉 0.05）. Propylthiouracil combined with triamcinolone treatment group, the levels of TSH were significant higher than before treatment （P 〈 0.05）, while the levels of FT3, FT4, TPOAb and TGAb were significant lower than before treatment （P 〈 0.05）. Conclusion The treatment of propylthiouracil combined with triamcinolone can significant decrease the levels of FT3,FT4,TPOAb and TGAb, prevent the development of AITD and promote the recovery of thyroid function.