中国临床药理学杂志2017，Vol.33Issue(22)：2250-2253,4.DOI:10.13699/j.cnki.1001-6821.2017.22.011
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
Clinical trial of dexamethasone combined with methimazole in the treatment of patients with chronic autoimmune thyroiditis
摘要
Abstract
Objective To investigate the clinical efficacy and safety profile of dexamethasone combined with methimazole in patients with chronic autoimmune thyroiditis.Methods A total of 36 patients with chronic autoimmune thyroiditis were randomly divided into treatment group (n =18) and control group (n =18).The control group received oral administration of methimazole 10 mg,tid.The treatment group were given dexamethasone injection 5 mg at day 1,8,15 and 22,on the basis of the control group.Both groups were treated for 28 d.After treatment,the clinical efficacy,the levels of serum T lymphocyte,tumor necrosis factor-α (TNF-α),thyroid stimulating hormone (TSH),free triiodothyronine (FT3),free thyroxine (FT4),antithyroperoxidase antibody (TPOAb),antithyroglobulin antibody (TGAb) and the adverse drug reactions were compared between the two groups.Results The total effective rates of the treatment group and the control group were 94.44％ (17 cases/18 cases) and 66.67％ (12 cases/18 cases),respectively,and the difference was statistically significant (P ＜ 0.05).After treatment,levels of serum CD4 +/CD8 + were 1.31 ± 0.07,1.00 ± 0.08 in treatment group and control group.The levels of TNF-α were (1.57 ± 0.16),(1.92 ± 0.16) ng · mL-1.The levels of FT3 were(2.85 ±0.78),(5.19 ± 1.04) pmol · L-1.The levels of FT4 were(13.08 ± 1.59),(18.96 ±2.21)pmol · L-1.The levels of TSH were(2.88 ±0.60),(3.85 ±0.81) U · mL-1.The levels of TPOAb were(22.92 ± 3.30),(27.43 ±4.45) U · mL-1.The levels of TGAb were (74.30 ± 11.22),(92.74 ± 13.46) U · mL-1,respectively.All the parameters between the two groups were statistically significant (P ＜ 0.05).The adverse drug reactions in patients of the treatment group were agitation,nausea and vomiting,and the incidence of adverse drug reactions was 11.11％ (2 cases/18 cases).The adverse drug reactions in patients of the control group were dizziness headache,nausea and vomiting,hypogeusia,and the incidence of adverse drug reaction was 22.22％ (4 cases/18 cases).There was no statistically significant differences in the incidence of adverse drug reactions between the two groups (P ＞ 0.05).Conclusion Dexamethasone combined with sulfhydryl imidazole exerted satisfying clinical efficacy and high safety profile on the treatment of chronic autoimmune thyroiditis.关键词
慢性自身免疫性甲状腺炎/地塞米松/甲巯咪唑/肿瘤坏死因子-α/T淋巴细胞Key words
chronic autoimmun thyroiditis/dexamethasone/methimazole/tumor necrosis factor-α/T lymphocyte分类
医药卫生引用本文复制引用
方永碧,何德全..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[J].中国临床药理学杂志,2017,33(22):2250-2253,4.基金项目
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) （2010-25-01-16）
