丙硫氧嘧啶联合比索洛尔治疗甲状腺功能亢进患者的效果及其对肝功能、心功能的影响

目的观察丙硫氧嘧啶联合比索洛尔治疗甲状腺功能亢进患者的效果及其对肝、心功能的影响。方法选取2017年1月-2019年1月湖南中医药高等专科学校附属第一医院内分泌科治疗甲状腺功能亢进患者90例,随机数字表法分为对照组、联合组,各45例。对照组患者口服丙硫氧嘧啶,联合组口服丙硫氧嘧啶、比索洛尔,疗程均为3个月。比较2组患者治疗效果,甲状腺功能、肝功能及心功能指标,不良反应发生率。结果联合组总有效率为97.78%,高于对照组的84.44%(χ2/P=4.939/0.026)。治疗后联合组T3、T4、FT3、FT4指标水平均低于对照组,TSH高于对照组(t/P=6.114/0.000、4.426/0.000、10.630/0.000、5.204/0.000、9.493/0.000)。治疗后联合组AST、ALT、ALP、TBil水平低于对照组(t/P=8.810/0.000、9.980/0.000、13.980/0.000、4.026/0.000)。治疗后联合组LVEF、左室高峰射血率(PER)和左室高峰充盈率(PFR)指标水平高于对照组(t/P=5.506/0.000、7.075/0.000、3.258/0.000)。联合组患者不良反应总发生率为13.33%,高于对照组11.11%,2组比较差异无统计学意义(P>0.05)。结论丙硫氧嘧啶联合比索洛尔治疗甲状腺功能亢进患者的效果显著,并能有效改善甲状腺功能及肝、心功能,且安全性好。

Effect of propylthiouracil combined with bisoprolol on hyperthyroidism and its influence on liver and heart function

Objective To observe the effect of propylthiouracil combined with bisoprolol in the treatment of hyperthyroidism and its effect on liver and heart function.Methods Ninety patients with hyperthyroidism were selected from the Department of Endocrinology of the First Affiliated Hospital of Hunan College of Traditional Chinese Medicine.from January 2017 to January 2019.Random number table method was divided into control group and combined group,45 cases each.The patients in the control group were given propylthiouracil orally,and the patients in the combined group were given propylthiouracil and bisoprolol orally.After 3 months the therapeutic effect,thyroid function,liver function and cardiac function indexes,and the incidence of adverse reactions were compared between the two groups.Results The total effective rate of the combined group was higher than the control group(97.78% vs.84.44%,χ~2/P=4.939/0.026).After treatment,the levels of T3,T4,FT3 and FT4 in the combined group were lower than those in the control group,and TSH was higher than the control group(t/P=6.114/0.000,t/P=4.426/0.000,t/P=10.630/0.000,t/P=5.204/0.000,t/P=9.493/0.000).The levels of AST,ALT,ALP and TBil in the combined group were lower than those in the control group(t/P=8.810/0.000,t/P=9.980/0.000,t/P=13.980/0.000,t/P=4.026/0.000).After treatment,the LVEF,left ventricular peak ejection rate(PER) and left ventricular peak filling rate(PFR) levels were higher in the combined group than in the control group(t/P=5.506/0.000,t/P=7.075/0.000,t/P=3.258/0.000).The total incidence of adverse reactions was 13.33% in the combined group,which was 11.11% higher than that in the control group.There was no significant difference between the two groups(P> 0.05).Conclusion Propylthiouracil combined with bisoprolol in the treatment of patients with hyperthyroidism has a significant effect,and can effectively improve the thyroid function and liver,heart function,with good safety.