小剂量丙基硫氧嘧啶联合普萘洛尔治疗亚临床甲亢合并阵发性房颤临床疗效观察

摘要

Objective To explore the clinical efficacy of low - dose methimazole and bisoprol therapy in patients with subclinical hyperthyroidism complicated by paroxysmal atrial fibrillation. Methods Fifty - six subclinical hyperthyroidism patients with paroxysmal atrial fibrillation were randomly divided into propylthiouracil plus propranolol group (group A, n =31, propylthiouracil 50 mg/d, oral intake: propranolol 10 mg/d, oral intake) and placebo group (group B, n = 25, the same amount of placebo). The changes of FT3 and FT4, TSH, cardiac function, TGAb positive rate and TPOAb positive rate of both groups were observed after treatment. Results After treatment, FT4 decreased significantly and TSH increased significantly in group A (P<0.01). Serum TGAb and TPOAb positive rates showed no significant difference in both groups after treatment. The average heart rate decreased significantly in group A (P < 0.05). Conclusion Low - dose propylthiouracil combined with propranolol for subclinical hyperthyroidism complicated with paroxysmal atrial fibrillation can improve the serum TSH level, reduce hypothyroidism phenomenon, improve cardiac function, and effectively alleviate atrial fibrillation.%目的 探讨小剂量丙基硫氧嘧啶联合普萘洛尔治疗亚临床甲亢合并阵发性房颤的临床疗效.方法 56例亚临床甲亢合并阵发性房颤患者,随机分为:丙基硫氧嘧啶联合普萘洛尔组(A组),31例,给予丙基硫氧嘧啶50 mg/d,口服,同时给予普萘洛尔10 mg/d,口服；安慰剂组(B组)25例,给予等量的安慰剂治疗.观察患者治疗前后FT3、FT4、TSH、心功能、TGAb阳性率、TPOAb阳性率变化情况.结果 A组治疗后FT4较治疗前明显下降(P＜0.01),TSH较治疗前显著升高(P＜0.01).2组治疗后,TGAb、TPOAb阳性率前后均无显著差异.A组治疗后平均心率显著下降(P＜0.05).结论 小剂量丙基硫氧嘧啶联合普萘洛尔对于亚临床甲亢合并阵发性房颤,可协同改善血清TSH水平,降低甲减现象,改善心脏功能,有效缓解房颤的发生.