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【摘要】目的探讨放射性碘联合小剂量甲巯咪唑治疗甲亢性心脏病的临床疗效及其安全性。

方法选取2013年1月～2015年1月收治的甲亢性心脏病患者102例为研究对象，按照治疗方法不同将其随机分为观察组和对照组各51例，对照组患者给予常规治疗并联合小剂量甲巯咪唑治疗，观察组患者在对照组基础上加用放射性碘治疗，比较两组患者的临床疗效，并分析药物不良反应情况。

结果治疗3、6、12个月时，两组患者的FT3、FT4水平均明显降低，与治疗前比较差异有统计学意义（P<0.01）；且观察组的FT3、FT4水平下降更明显，与对照组比较差异有统计学意义（P<0.01）；观察组治疗总有效率为94.12%，明显高于对照组的70.59%，组间比较差异有统计学意义（P<0.01）；两组患者治疗期间未发现严重不良反应。

结论放射性碘联合小剂量甲巯咪唑治疗甲亢性心脏病临床疗效好，安全性高，值得临床推广应用。

【关键词】放射性碘；甲亢性心脏病；小剂量；安全性

中图分类号：R541.8+5文献标识码：ADOI：10.3969/j.issn.10031383.2017.02.022

【Abstract】ObjectiveTo investigate clinical efficacy and safety of radioactive iodine combined with lowdose methimazole in the treatment of hyperthyroid heart disease.

Methods102 patients with hyperthyroid heart disease admitted to hospital from January，2013 to January，2015 were selected as study subjects，and they were randomly divided into observation group and control group with 51 cases in each group according to different treatment methods.The control group were given conventional treatment combined with lowdose methimazole，and based on which the observation group were treated with radioactive iodine.Clinical efficacy of the two groups were compared，and adverse drug reactions were analyzed.

Results3 months，6 months and 12 months of treatment，FT3 and FT4 levels significantly reduced in both groups，and compared with those before treatment，difference was statistically significant （P<0.01）.And FT3 and FT4 of the observation group decreased more significantly，and compared with those of the control group，difference was statistically significant（P<0.01）.Total effective rate of the observation group was 94.12%，significantly higher than that （70.59%） of the control group，there was statistically significant difference between the two groups（P<0.01）.No serious adverse reactions were found during the treatment of the two groups.

ConclusionRadioactive iodine combined with lowdose methimazole has good clinical curative effects in the treatment of hyperthyroid heart disease with high safety.Thus，it is worthy of clinical promotion and application.

【Key words】radioactive iodine；hyperthyroid heart disease；lowdose；safety

甲亢性心臟病是临床常见的甲亢并发症之一，其发病机制为：人机体甲状腺功能亢进所产生的甲状腺素能直接或间接对心脏功能产生影响，久之则能引发心肌梗死、心力衰竭等内分泌代谢紊乱性心脏疾病[1]。有效控制甲亢是治疗该症的主要方法，以往临床上主要采取外科切除手术和药物治疗的方法，虽然取得一定疗效，但外科手术影响甲状腺自身功能，也易引发相关并发症，而药物治疗也未找到疗效确切的显效药物。……