目的探討甲巰咪唑和丙硫氧嘧啶對甲狀腺功能亢進(jìn)患者肝功能影響的療效。方法選取80例甲狀腺功能亢進(jìn)患者,隨機(jī)分為兩組,甲組（41例）口服甲巰咪唑,乙組（39例）口服丙硫氧嘧啶片。觀察并記錄兩組患者治療前后甲狀腺功能指標(biāo),肝功能指標(biāo),肝功能受損情況及治療期間不良反應(yīng)情況,評價(jià)甲巰咪唑和丙硫氧嘧啶對甲狀腺功能亢進(jìn)患者肝功能的影響。結(jié)果治療前,兩組患者由于甲狀腺功能亢進(jìn),三碘甲腺原氨酸（FT₃）、四碘甲腺原氨酸（FT₄）均處于高水平狀態(tài),且差異無統(tǒng)計(jì)學(xué)意義。促甲狀腺激素（TSH）分泌受到抑制,處于較低水平。治療后,患者甲狀腺功能亢進(jìn)癥狀有所改善,患者FT₃、FT₄較治療前降低,TSH較治療前升高（P<0.05）,但組間比較差異無統(tǒng)計(jì)學(xué)意義。治療前,兩組丙氨酸氨基轉(zhuǎn)移酶（ALT）、天冬氨酸氨基轉(zhuǎn)移酶（AST）、谷氨酰轉(zhuǎn)肽酶（GGT）水平相比,差異無統(tǒng)計(jì)學(xué)意義。治療后乙組ALT、AST、GGT水平均有所升高,并明顯高于甲組（P<0.05）,其中,以ALT變化最為明顯；甲組治療前后無明顯變化。治療期間,甲組患者出血5例肝損傷,乙組14例肝損傷,乙組患者肝損傷比例明顯高于甲組（P<0.05）,乙組患者肝臟損傷發(fā)生時間明顯晚于甲組（P<0.05）。治療期間,兩組不良反應(yīng)發(fā)生率無統(tǒng)計(jì)學(xué)差異。結(jié)論甲巰咪唑與丙硫氧嘧啶對甲狀腺功能亢進(jìn)的療效相當(dāng)。與丙硫氧嘧啶相比,甲巰咪唑?qū)Ω闻K損傷程度較小,但服藥后較早引起肝臟損傷,建議在甲狀腺功能亢進(jìn)治療期間,應(yīng)定期復(fù)查患者肝功能。

Objective To compare methimazole and propylthiouracil affecting liver function by treating hyperthyroidism. Methods Total 80 patients with hyperthyroidism were randomly divided into two groups. Group A (41 cases) was given methimazole, group B (39 cases) was given propylthiouracil. The effect of methimazole and propylthiouracil affecting liver function by treating hyperthyroidism was evaluated by the indexes of thyroid function, liver function, liver damage, and adverse reaction during treatment. Results Before treatment, there were no statistical significance on FT₃ and FT₄ between two groups. After treatment, the FT₃and FT₄ were decreased and TSH was increased in two groups (P < 0.05). But there were no statistical significance between two groups. Before treatment, there was no statistical significance on ALT, AST, and GGT between two groups. After treatment, the ALT, AST, and GGT increased in group B and higher than that of group A (P < 0.05). The ALT, AST, and GGT had no change before and after treatment in the group A. During treatment, there were five cases of liver injury in group A and 14 cases in group B. The liver injury rate of group B was higher than that of group A (P < 0.05) and injury time of group B was later than that of group A. During treatment, there was no statistical significance on adverse reaction rate between two groups. Conclusion The efficacy of methimazole was equal to propylthiouracil in treating hyperthyroidism. Compared with propylthiouracil, the methimazole had less injury on liver but induce the liver injury in earlier. It is suggested that the patients should check the liver function regularly during treatment.