Comparison of the effects of propylthiouracil and methimazole in the treatment of hyperthyroidism / 中国基层医药

ABSTRACT

Objective To compare the effects of propylthiouracil and methimazole in the treatment of hyperthyroidism.Methods From January 2014 to January 2015,100 patients with hyperthyroidism in Tengnan Hospital of Zaozhuang Mining Group were selected as study objects,and they were divided into control group and research group according to the digital table,with 50 cases in each group.The control group was treated with propylthiouracil,the research group was treated with methimazole.The clinical effects,thyroid associated antibody level,other relevant indicators and adverse reactions between two groups were compared.Results The total effective rate of the research group was higher than that of the control group(84％ vs.80％),the difference was not statistically significant (x2 =0.271,P ＞ 0.05).Before treatment,the thyrotropin receptor antibody(TRAb) and anti-thyroid peroxidase antibody (TPOAb) between the two groups had no statistically significant differences(t =0.141,0.199,all P ＞ 0.05).After treatment,TRAb of the research group was lower than that of the control group [(7.84 ± 4.26) U/L vs.(8.67 ±4.48) U/L],TPOAb of the research group was higher than that of the control group[(167.62 ± 45.53) IU/mL vs.(158.37 ± 49.40) IU/mL],but the differences were not statistically significant (t =0.949,0.974,all p ＞ 0.05).After treatment,FT3 [(7.34 ± 2.36) pmol/L vs.(13.78 ± 2.91) pmoL/L] and FT4 [(18.52 ± 6.79) pmol/L vs.(23.71 ±6.52) pmol/L] of the research group were lower than those of the control group,the differences were significantly significant (t =12.154,3.899,all P ＜0.05).In the 2 years follow-up,24 cases(48％) in the research group stopped taking medicine,and 14 cases(28％) in the control group,the rate between the two groups had statistically significant difference (x2 =4.244,P ＜ 0.05).The thyroid-stimulating hormone (TSH) recovery time,symptom control time,liver injury time of the research group were (7.45 ± 4.01) months,(6.86 ± 3.49) weeks,(20.85 ± 8.34) d,respectively,which were shorter than those of the control group [(10.36 ± 5.14) months,(9.75 ± 3.42)weeks,(39.21 ± 27.65) d],the differences were statistically significant(t =4.i82,3.156,4.495,all P ＜ 0.05).The incidence rate of liver injury and total incidence rate of adverse reaction of the research group were 8％,54％,which were significantly lower than those of the control group (22％,74％) (x2 =3.843,4.340,all P ＜ 0.05).Conclusion Both propylthiouracil and methimazole have good treatment effects in hyerthyroidism,but methimazole works rapidly,and with good safety.