性别差异对甲亢患者药物治疗进入减药期时间的影响

Influence of gender difference on the timing to reduce the initial dose of antithyroid drugs in patients with hyperthyroidism

关键词:  甲状腺功能亢进症  抗甲状腺药物  丙基硫氧嘧啶

Key words:  hyperthyroidism  antithyroid agents  propylthiouracil

摘要:

［目的］ 观察甲状腺功能亢进症（甲亢）患者服用丙基硫氧嘧啶后进入减药期的时间及性别差异对患者进入减药期时间的影响。［方法］ 收集68例初诊的原发性甲亢患者，男性组26例，女性组42例，均给予丙基硫氧嘧啶300 mg/d口服治疗。服药后每2周检测1次血液常规；每2周检测1次FT₃、FT₄及TSH，每个月检测1次肝功能。临床症状缓解及FT₃、FT₄、TSH恢复正常后进入减药期，共随访6个月。计算所有患者进入减药期的平均时间，并观察不同性别患者进入减药期的时间是否存在统计学差异。［结果］ 68例患者服用丙基硫氧嘧啶后1～2周症状开始缓解，服药4周FT₃、FT₄及TSH开始恢复正常。治疗前后甲状腺功能明显改善（P<0.05）。68例患者在随访结束时均进入减药期，进入减药期的平均时间为（45.38±21.37）d，其中男性组平均为（41.88±19.33）d，女性组平均为（48.26±22.42）d。两组进入减药期的时间差异有统计学意义（P<0.05）。［结论］ 甲亢患者服用丙基硫氧嘧啶后约在4～8周进入减药期；女性患者进入减药期的时间迟于男性患者。

Abstract:

［Objective］ To evaluate the time when to reduce the initial dose of propylthiouracil(PTU) in patients with hyperthyroidism,and also to observe whether the gender influences the mean duration. ［Methods］ Sixty-eight patients, 26 males and 42 females collected in our clinics from Jan.2008 to Jun.2008 were treated with PTU 300 mg/d as initial dose. After the treatment, routine blood test and the serum free T₄ (FT₄, T₃ (FT₃) and TSH were examined every 2 weeks,and liver function was checked monthly. Initial dose of PTU was continued until the achievement of the euthyroid state and the serum TSH, FT₄, FT₃ levels were in the normal range. The total following-up duration was 6 months. The mean durations of the administration of the initial dose of PTU was recorded and whether the gender difference affecting the time of reducing the initial dose was observed. ［Results］ The symptoms of all the 68 patients started to be released after 1~2 week of the treatment. Four weeks later the serum TSH, FT₄, FT₃ levels began to return to normal. After the PTU treatment,the thyroid function was significantly improved (P<0.05). When the study was ended, all the patients reduced the initial dose of PTU. Although there were no significant differences in age, thyroid function, duration of the disease or the initial doses of PTU, the mean duration of the administration of the initial dose of PTU in female group was significantly longer than those in male group (P<0.05). ［Conclusion］ The mean duration of the administration of the initial dose of PTU is 4~8 weeks after medication.And the mean duration of the administration of the initial dose of PTU in women is significantly longer than that in men.