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目的:对比观察甲硫咪唑与丙硫氧嘧啶对甲亢患者疗效及外周血白细胞的影响。方法:选取本院治疗的甲亢患者121例分为两组,对照组62例按病情轻重采用不同剂量丙硫氧嘧啶治疗,观察组59例按病情轻重采用不同剂量甲硫咪唑治疗,于治疗前、治疗后4周、8周、12周测定游离甲状腺素(FT4)、游离三碘甲状腺原氨酸(FT3)水平,检测白细胞计数、中性粒细胞计数,同时记录治疗后白细胞减少发生状况。结果:与治疗前比较,两组患者治疗后FT3、FT4水平均显著下降(P<0.01),观察组在治疗4周、治疗8周、治疗12周FT3水平均显著低于对照组(P<0.01),观察组治疗8周、治疗12周FT4水平低于对照组(P<0.05);两组患者治疗前后不同时间点白细胞计数及中性粒细胞计数比较,差异无统计学意义(P>0.05),在治疗8周时,两组间中性粒细胞比较,差异具有统计学意义(P<0.05);对照组和观察组不同病情程度间白细胞减少率比较,差异无统计学意义(P>0.05),在轻度患者中,两组间比较,差异具有统计学意义(P<0.05),在中、重度患者中,两组间比较,差异无统计学意义(P>0.05)。结论:按病情轻重程度选择不同剂量甲硫咪唑治疗对甲亢效果更加显著,对白细胞计数影响不随剂量变化而变化,在小剂量时白细胞减少要低于丙硫氧嘧啶。
OBJECTIVE: To compare the effects of methimazole and propylthiouracil on the therapeutic efficacy and peripheral blood leucocytes in patients with hyperthyroidism. Methods: 121 patients with hyperthyroidism treated in our hospital were divided into two groups, 62 patients in the control group were treated with propylthiouracil in different doses according to the severity of the disease, 59 patients in the observation group were treated with methimazole at different doses according to their severity. (FT4) and free triiodothyronine (FT3) were measured at 4 weeks, 8 weeks and 12 weeks after treatment. The white blood cell count and neutrophil count were measured. The incidence of leukopenia after treatment was also recorded. Results: Compared with those before treatment, FT3 and FT4 levels decreased significantly in both groups (P <0.01). After treatment for 4 weeks and 8 weeks, FT3 levels in the observation group were significantly lower than those in the control group (P < 0.01). The observation group was treated for 8 weeks and the FT4 level was lower in the 12-week treatment group than that in the control group (P <0.05). There was no significant difference in the white blood cell count and neutrophil count between the two groups before and after treatment (P> 0.05). There was a significant difference in the neutrophilic granulocyte count between the two groups at 8 weeks of treatment (P <0.05). There was no significant difference in leukopenia between control group and observation group (P > 0.05). In mild patients, the difference between the two groups was statistically significant (P <0.05). There was no significant difference between the two groups in moderate and severe patients (P> 0.05). Conclusion: The treatment of thyrotropin with different doses of methimazole according to the severity of the disease is more significant. The effect on the white blood cell count does not change with dose, and the leukopenia is lower than propylthiouracil at low dose.