甲巯咪唑和丙硫氧嘧啶对甲状腺功能亢进症患者肝功能影响的研究

目的：探讨甲巯咪唑（MMI）和丙硫氧嘧啶（PTU）对甲状腺功能亢进症患者肝功能的影响研究。方法：选取我院2010年1月-2012年12月收治的120例甲状腺功能亢进症患者,所有患者经相关的实验室检查符合甲状腺功能亢进。将120例患者按照数字随机分组的方法分为两组,分别为MMI治疗组60例及PTU治疗组60例,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进行维持治疗,观察两组患者治疗后肝功能各项指标的变化情况。结果：研究结果显示,PTU治疗组导致肝损伤的发生率为18.3%,MMI治疗组导致肝损伤发病率为8.3%,两组相比,差异有统计学意义,P〈0.05;并且在肝功能损伤出现时间上也有所不同,MMI组为（18.4±7.6）d,PTU组为（38.8±8.2）d,两组间比较差异有统计学意义,P〈0.05;两组患者肝功能损伤指标中均以ALT升高为主,其中MMI组ALT升高发生率为5.0%,PTU组ALT升高发生率为16.7%;两组差异有统计学意义,P〈0.05。结论：丙硫氧嘧啶较甲巯咪唑更易出现肝损伤,但甲巯咪唑出现肝损伤时间稍早于丙硫氧嘧啶;两组患者肝损伤以ALT升高为主,多数为轻度性肝损伤。

Influence Study on Liver Function of Hyperthyroidism Patients by Methyl Sulfhydryl Imidazole and Propylthiouracil

Objective： To investigate the liver function of hyperthyroidism patients by methyl sulfhydryl imidazole and propylthiouracil.Methods One hundred and twenty hyperthyroidism patients who were treated in our hospital from January 2010 to December 2012 were chosen as the research objects,All patients were randomly divided into the MMI PTU treatment group （60 cases） and PTU treatment group （60 cases）,initial dose of sulfhydryl imidazole was 30 rag/d, propylthiouracil was 300 mg/d,respectively,they gradually reduced to ash imidazole 5~10 mg/d, propylthiouracil 50~100mg/d in maintenance treatment according to patient condition, liver function changes after the drug was evaluated.Results The incidence of liver damage resulted by PTU was 18.3%, the incidence of liver damage resulted by MMI was 8.3%,there were statistically significant difference between the two groups （P〈0.05）.Two groups in liver injury time is different,MMI group was （18.4＋7.6） days,PTU group was （38.8＋8.2） days, there were statistically significant difference between the two groups （P〈0.05）,liver damage caused by methyl sulfhydryl imidazole and propylthiouracil were predominantly ALT elevations,the incidence of elevated ALT in MMI group was 5.0%, incidence of ALT elevations in PTU group was 16.7%, there were statistically significant difference between the two groups （P〈0.05）.Conclusion The propylthiouracil is prone to methyl sulfhydryl imidazole in liver damage, methyl sulfhydryl imidazole is earlier than that propylthiouracil,propyhhiouracil and methyl sulfhydryl imidazole caused by liver damage mostly mild liver damage, all give priority to elevated ALT.