地塞米松联合甲巯咪唑治疗慢性自身免疫性甲状腺炎的临床研究

发布时间：2019-03-19 21:33

【摘要】：目的观察地塞米松联合甲巯咪唑对慢性自身免疫性甲状腺炎的临床疗效及安全性。方法将36例慢性自身免疫性甲状腺炎患者随机分成试验组18例及对照组18例。对照组予以口服甲巯咪唑10 mg tid;试验组在对照组治疗的基础上,于治疗第1,8,15,22天甲状腺内肌内注射地塞米松5 mg。2组患者均治疗28 d。比较2组的临床疗效、治疗前后血清T淋巴细胞、肿瘤坏死因子α(TNF-α)水平、血清人促甲状腺素(TSH)、游离三碘甲状腺原氨酸(FT_3)、游离甲状腺素(FT_4)、抗甲状腺过氧化物酶抗体(TPOAb)和抗甲状腺球蛋白抗体(TGAb)等指标水平及药物不良反应发生情况。结果试验组和对照组的总有效率分别为94.44%(17例/18例)和66.67%(12例/18例),差异有统计学意义(P0.05);治疗后,试验组和对照组的CD4~+/CD8~+分别为1.31±0.07,1.00±0.08;TNF-α分别为(1.57±0.16),(1.92±0.16)ng·mL~(-1);FT_3分别为(2.85±0.78),(5.19±1.04)pmol·L~(-1);FT_4分别为(13.08±1.59),(18.96±2.21)pmol·L~(-1);TSH分别为(2.88±0.60),(3.85±0.81)U·mL~(-1);TPOAb分别为(22.92±3.30),(27.43±4.45)U·mL~(-1);TGAb分别为(74.30±11.22),(92.74±13.46)U·mL~(-1);差异均有统计学意义(均P0.05)。试验组出现的药物不良反应有激动不安、恶心呕吐,对照组出现的药物不良反应有头晕头痛、恶心呕吐、味觉减退。试验组和对照组的药物不良反应发生率分别为11.11%(2例/18例)和22.22%(4例/18例),差异无统计学意义(P0.05)。结论地塞米松联合甲巯咪唑治疗慢性自身免疫性甲状腺炎临床疗效较好,安全性较高。
[Abstract]:Objective to observe the clinical efficacy and safety of dexamethasone combined with methimidazole in the treatment of chronic autoimmune thyroiditis. Methods 36 patients with chronic autoimmune thyroiditis were randomly divided into test group (n = 18) and control group (n = 18). The control group received oral methimidazole 10 mg tid; on the basis of the control group. On the 1,8,15,22 days after treatment, the patients in the control group were treated with intramuscular injection of dexamethasone (5 mg.2) for 28 d. The clinical efficacy, serum T lymphocyte, tumor necrosis factor 伪 (TNF- 伪), free triiodothyronine (FT_3) and free thyroxine (FT_4) of human thyrotropin (TSH), before and after treatment were compared between the two groups. The level of anti-thyroid peroxidase antibody (TPOAb) and anti-thyroglobulin antibody (TGAb) and the occurrence of adverse drug reactions. Results the total effective rates of test group and control group were 94.44% (17 / 18) and 66.67% (12 / 18) respectively (P0.05). After treatment, the CD4~ / CD8~ ratio was 1.31 卤0.07,1.00 卤0.08), (and (1.57 卤0.16), (1.92 卤0.16) ng 路mL ~ (- 1), respectively. FT_3 and FT_4 were (2.85 卤0.78), (5.19 卤1.04) pmol 路L ~ (- 1), (13.08 卤1.59), () and (18.96 卤2.21) pmol 路L ~ (- 1), respectively. TSH was (2.88 卤0.60), (3.85 卤0.81) U 路mL ~ (- 1); TPOAb was (22.92 卤3.30), () and (27.43 卤4.45) U 路mL ~ (- 1), respectively. TGAb was (74.30 卤11.22), (92.74 卤13.46 U 路mL ~ (- 1), the difference was statistically significant (P 0.05). The adverse drug reactions in the test group were agitation, nausea and vomiting, and those in the control group were dizziness and headache, nausea and vomiting, and decreased taste. The incidence of adverse drug reactions was 11.11% (2 / 18) in the test group and 22.22% (4 / 18) in the control group. There was no significant difference between the two groups (P0.05). Conclusion Dexamethasone combined with methimidazole is effective and safe in the treatment of chronic autoimmune thyroiditis.
【作者单位】：重庆南桐矿业公司总医院内分泌科;
【基金】：国家医学教育发展中心医学研究课题基金资助项目(2010-25-01-16)
【分类号】：R581.4

【相似文献】