目的 探討碳酸鋰聯(lián)合甲巰咪唑治療甲狀腺功能亢進的臨床療效。方法 選取2014年2月—2015年2月延安大學附屬醫(yī)院收治的甲狀腺功能亢進患者92例,隨機分為對照組和治療組,每組各46例。對照組口服甲巰咪唑片,10～15 mg/次,2次/d,患者病情得到控制后,逐漸減輕劑量至5～10 mg/d。治療組在對照組治療基礎上口服碳酸鋰片,0.50 g/d,病情控制后0.25 g/d。兩組患者同時給予保肝治療,白細胞減少患者結合升白細胞藥物治療。兩組患者均連續(xù)治療6個月。觀察兩組的臨床療效,同時比較治療前后兩組血清游離甲狀腺素(FT₄)、游離三碘甲狀腺原氨酸(FT₃)、總T₃(TT₃)、總T₄(TT₄)、促甲狀腺素(TSH)的變化情況。結果 治療后,對照組和治療組的總有效率分別為71.74%、93.48%,兩組總有效率比較差異具有統(tǒng)計學意義(P< 0.05)。兩組患者TT₃、TT₄、FT₃、FT₄均顯著降低,TSH顯著升高,同組治療前后差異具有統(tǒng)計學意義(P< 0.05),且治療組這些觀察指標的改善程度優(yōu)于對照組,兩組比較差異具有統(tǒng)計學意義(P< 0.05)。結論 碳酸鋰聯(lián)合甲巰咪唑治療甲狀腺功能亢進具有較好的臨床療效,可改善甲狀腺功能相關激素水平,具有一定的臨床推廣應用價值。

Objective To observe the clinical efficacy of lithium carbonate combined with thiamazole in treatment of thyroid function hyperfunction. Methods Patients (92 cases) with thyroid function hyperfunction in Yan'an University Affiliated Hospital from February 2014 to February 2015 were randomly divided into control and treatment groups, and each group had 46 cases. The patients in the control group were po administered with Thiamazole Tablets, 10—15 mg/time, twice daily. After the morbidity of patients was in remission, the dosage was gradually reduced to 5—10 mg/d. The patients in the treatment group were po administered with Lithium Carbonate Tablets on the basis of the control group, 0.50 g/d, and 0.25 g/d after disease was control. The patients in two groups were accepted the protect liver treatment, and patients with leucopenia were given drug therapy. The patients in two groups were treated for 6 months. After treatment, the efficacy was evaluated, and the changes of TT₃, TT₄, FT₃, FT₄, and TSH in two groups before and after treatment were compared. Results After treatment, the efficacies in the control and treatment groups were 71.74% and 93.48%, respectively, and there were differences between two groups (P < 0.05). After treatment, TT₃, TT₄, FT₃, and FT₄ were significantly decreased, TSH was significantly increased, and the difference was statistically significant in the same group (P < 0.05). These observed indexes in the treatment group were better than those in the control group, with significant difference between two groups (P < 0.05). Conclusion Lithium carbonate combined with thiamazole has curative effect in treatment of thyroid function hyperfunction, and can improve the levels of hormones related thyroid function, which has a certain clinical application value.