本文選題：甲狀腺功能亢進(jìn)癥 + 房性顫動(dòng)��； 參考：《山東醫(yī)藥》2017年37期

【摘要】：目的觀察高劑量(30 mg)普萘洛爾治療甲狀腺功能亢進(jìn)癥(甲亢)合并房性顫動(dòng)(房顫)的臨床效果。方法將98例甲亢合并房顫患者采用抽簽法隨機(jī)分為高劑量組與低劑量組各49例。兩組均給予丙硫氧嘧啶治療,低劑量組加普萘洛爾10 mg/次,高劑量組加普萘洛爾30 mg/次,均3次/d口服,連續(xù)治療6周。分別于治療前后檢測(cè)血清游離三碘甲狀腺原氨酸(FT3)、游離甲狀腺素(FT4)、促甲狀腺激素(TSH)、促甲狀腺受體抗體(TRAb)、甲狀腺球蛋白抗體(TGAb)、甲狀腺過(guò)氧化物酶抗體(TPOAb),計(jì)算TGAb、TPOAb陽(yáng)性率;評(píng)價(jià)兩組HR、左室射血分?jǐn)?shù)(LVEF)及房顫發(fā)生情況;統(tǒng)計(jì)兩組用藥期間發(fā)生的不良反應(yīng)。結(jié)果與治療前比較,治療后兩組血清FT3、FT4、TRAb水平降低,血清TSH水平升高(P均0.05),且高劑量組以上指標(biāo)變化更明顯(P均0.05)。兩組治療前后TGAb、TPOAb陽(yáng)性率比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P均0.05)。治療后兩組HR、LVEF均改善(P均0.05),高劑量組改善更明顯(P均0.05)。高劑量組房顫發(fā)生率低于低劑量組(P0.05)。兩組不良反應(yīng)發(fā)生率比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論與低劑量(10 mg)比較,高劑量(30 mg)普萘洛爾治療甲亢合并房顫效果更佳。
[Abstract]:Objective to observe the clinical effect of high dose (30 mg) propranolol on hyperthyroidism (hyperthyroidism) with atrial fibrillation (AF). Methods 98 patients with hyperthyroidism complicated with atrial fibrillation were randomly divided into high dose group (49 cases) and low dose group (49 cases). Both groups were given propranolol for 10 mg/ in low dose group and propranolol for 30 mg/ in high dose group. Each group was given oral propranolol 3 times / d for 6 weeks. Serum free triiodothyronine (FT 3), free thyroxine (FT 4), thyrotropin (TSH), thyrotropin receptor antibody (TRAB), thyroglobulin antibody (TGAb), thyroid peroxidase antibody (TPOAb) were detected before and after treatment. HRF left ventricular ejection fraction (LVEF) and atrial fibrillation were evaluated. Results compared with those before treatment, the levels of serum FT _ 3N, FT _ 4T _ 4 TRAB decreased and serum TSH increased in both groups (P 0.05), and the changes of above indexes were more obvious in the high dose group (all P 0.05). There was no significant difference in the positive rate of TGAb-TPOAb between the two groups before and after treatment (P 0.05). After treatment, the LVEF of HRT was improved in both groups (P 0.05), especially in the high dose group (P 0.05). The incidence of atrial fibrillation in high dose group was lower than that in low dose group (P0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P0.05). Conclusion compared with low dose (10 mg), high dose (30 mg) propranolol is more effective in the treatment of hyperthyroidism with atrial fibrillation.
【作者單位】： 襄陽(yáng)市中心醫(yī)院·湖北文理學(xué)院附屬醫(yī)院;襄陽(yáng)市第一人民醫(yī)院;
【分類號(hào)】：R541.75;R581.1

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