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目的探讨甲巯咪唑(MMI)与丙硫氧嘧啶(PTU)对Graves病(GD)患者细胞因子的影响。方法选取2013年6月—2014年6月南京市中西医结合医院收治的GD患者63例,随机分为MMI组(31例)和PTU组(32例)。MMI组患者予以MMI治疗,PTU组患者予以PTU治疗。观察两组患者临床疗效、治疗前后细胞因子〔白介素-2(IL-2)、白介素-6(IL-6)及促甲状腺素受体抗体(TRAb)〕水平及不良反应发生情况。结果两组患者总有效率比较,差异无统计学意义(P>0.05);治疗前两组患者IL-2、IL-6、TRAb水平比较,差异无统计学意义(P>0.05),治疗6个月MMI组患者IL-2水平高于PTU组,IL-6、TRAb水平低于PTU组,差异有统计学意义(P<0.05);两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论 MMI与PTU治疗GD的效果相当,但MMI的免疫抑制作用强于PTU,药物t1/2长于PTU,故临床更倾向于使用MMI。
Objective To investigate the effects of methimazole (MMI) and propylthiouracil (PTU) on cytokines in Graves’ disease (GD). Methods Sixty-three GD patients admitted to Nanjing Hospital of Integrated Traditional Chinese and Western Medicine from June 2013 to June 2014 were randomly divided into MMI group (31 cases) and PTU group (32 cases). MMI patients treated with MMI, PTU patients treated with PTU. The clinical curative effect was observed in both groups. The levels of interleukin-2 (IL-2), interleukin-6 (IL-6) and thyrotropin-receptor antibody (TRAb) and the incidence of adverse reactions before and after treatment were observed. Results There was no significant difference in the total effective rate between the two groups (P> 0.05). There was no significant difference in the levels of IL-2, IL-6 and TRAb between the two groups before treatment (P> 0.05) The levels of IL-2 in MMI group were higher than those in PTU group and the levels of IL-6 and TRAb were lower in PTM group than in PTM group (P <0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P> 0.05). Conclusions The effect of MMI and PTU in treatment of GD is similar, but the immunosuppressive effect of MMI is stronger than that of PTU. The drug t1 / 2 is longer than that of PTU, so MMI is more likely to be used clinically.