潘文　安淑媛　杨爱琴　王宗玲

【摘要】 目的：探討普萘洛尔联合甲巯咪唑治疗甲状腺功能亢进的临床疗效，分析其对骨代谢的影响。方法：选取2014年10月-2017年12月本院收治的甲状腺功能亢进患者86例。按照入院先后顺序将其分为对照组（先入院）和研究组（后入院），各43例。对照组单独给予甲巯咪唑治疗，研究组联合甲巯咪唑与普萘洛尔治疗。比较两组治疗前后的甲状旁腺激素（PTH）、血清降钙素（CT）、骨钙素（BGP）、血清游离甲状腺素（FT4）、血清游离三碘甲腺原氨酸（FT3）及促甲状腺激素（TSH）水平，分析疗效及不良反应。结果：研究组总有效率为95.3%，高于对照组的79.1%（字2=11.756，P=0.001）；治疗后，研究组PTH、TSH水平均高于对照组，CT、BGP、FT4、FT3均低于对照组，比较差异均有统计学意义（P<0.05）；两组不良反应发生率比较差异无统计学意义（字2=0.442，P=0.505）。结论：甲状腺功能亢进临床治疗中，普萘洛尔与甲巯咪唑联合用药，不仅疗效显著，而且可改善骨代谢水平，无明显不良反应，安全性高。

【关键词】 普萘洛尔； 甲巯咪唑； 甲状腺功能亢进； 骨代谢； 影响

Efficacy of Propranolol Combined with Methimazole in Treatment of Hyperthyroidism and Its Effect on Bone Metabolism/PAN Wen，AN Shuyuan，YANG Aiqin，et al.//Medical Innovation of China，2018，15（27）：0-102

【Abstract】 Objective：To investigate the clinical efficacy of Propranolol combined with Methimazole in treatment of hyperthyroidism and analyze the effects of propranolol on bone metabolism.Method：A total of 86 patients with hyperthyroidism admitted to our hospital from October 2014 to December 2017 were selected.According to the order of admission，they were divided into control group（admission first） and study group（admission later），43 cases in each group.The control group was treated with Methimazole alone，and study group was treated with Methimazole and Propranolol.The levels of parathyroid hormone（PTH），serum calcitonin（CT），osteocalcin（BGP），serum free thyroxine（FT4），serum free triiodothyronine（FT3） and thyroid stimulating hormone（TSH） before and after treatment between two groups were compared，and the efficacy and adverse reactions were analyzed.Result：The total effective rate of study group was 95.3%，which was higher than 79.1% in control group（字2=11.756，P=0.001）.After treatment，the levels of PTH and TSH in study group were higher than those of control group，and the levels of CT，BGP，FT4 and FT3 were all lower than those of control group，the differences were statistically significant（P<0.05）.The incidence of adverse reactions between two groups were compared，the difference was not statistically significant（字2=0.442，P=0.505）.Conclusion：In the clinical treatment of hyperthyroidism，the combination of Propranolol and Methimazole has not only remarkable curative effect，but also can improve bone metabolism level，without obvious adverse reactions and high safety.

【Key words】 Propranolol； Methimazole； Hyperthyroidism； Bone metabolism； Influence

First-authors address：Qingdao Fuwai Cardiovascular Disease Hospital，Qingdao 266034，China

doi：10.3969/j.issn.1674-4985.2018.27.026

甲状腺功能亢进（hyperthyroidism）是临床常见的内分泌疾病，简称甲亢，相比而言，女性发病率比男性高[1-2]。临床上，患者多伴有多汗、消瘦、突眼、心悸、视力减退、体质量下降等表现，增加消化、神经及循环等系统兴奋性，以代谢亢进为显著特征，严重危害患者身心健康[3-4]。近些年研究证实，甲状腺功能亢进发病率逐年升高，成为危害患者身心健康的重要疾病[5]。因此，临床医师及专家学者十分关注本病治疗方法的探讨。为了探讨研究普萘洛尔联合甲巯咪唑治疗甲状腺功能亢进疗效和对骨代谢的影响，本文笔者将2014年10月-2017年12月收治的86例甲状腺功能亢进患者分成两组，采取不同方案进行治疗。现报道如下。

1 资料与方法