摘要:
目的 探讨小剂量丙基硫氧嘧啶与普萘洛尔配合治疗亚临床甲亢合并阵发性房颤临床效果.方法 选取该院2015年1月-2017年1月收治的亚临床甲亢合并阵发性房颤患者100例随机分为两组,对照组(n=50)给予普萘洛尔治疗,观察组(n=50)在对照组基础上给予小剂量丙基硫氧嘧啶治疗,对比两组患者临床疗效和治疗前后甲状腺功能以及房颤发生率和心率.结果 两组患者临床疗效94.00%/78.00%对比差异明显,观察组显著高于对照组,差异有统计学意义(χ2=10.631 2,P<0.05).治疗后观察组患者血清游离甲状腺素水平(10.16±1.78)pmol/L明显低于对照组(17.99±1.81)pmol/L,促甲状腺素水平(4.01±0.26)pmol/L明显高于对照组(0.19±0.06)pmol/L,差异有统计学意义(t=21.809 8、101.229 8,P<0.05).治疗后观察组患者房颤发生率和心率分别为24.00%、(79.6±17.0)次/min,明显低于对照组92.00%、(100.6±18.7)次/min,差异有统计学意义(χ2=94.909 7、t=5.875 7,P<0.05).结论对亚临床甲亢合并阵发性房颤采用小剂量应用丙基硫氧嘧啶联合普萘洛尔治疗可有效改善心脏功能,降低甲减现象和房颤发生,值得临床推广.%Objective To investigate the clinical effects of low-dose propylthiouracil combined with propranolol in the treatment of subclinical hyperthyroidism complicated with paroxysmal atrial fibrillation. Methods 100 patients with subclinical hyperthyroidism complicated with paroxysmal atrial fibrillation admitted to the hospital (January 2015 to January 2017) were randomly divided into two groups. The control group (n=50) was treated with propranolol. The observation group (n=50) was given a small dose of propylthiouracil on the basis of the control group. The clinical efficacy and the thyroid function and the incidence of atrial fibrillation and heart rate were compared before and after treatment.Results The clinical efficacy of the two groups was 94.00%/78.00%, and the observation group was significantly higher than the control group, which was statistically significant (χ2=10.631 2, P<0.05). After treatment, the serum free thyroxine level in the observation group was (10.16±1.78) pmol/L, which was significantly lower than that in the control group (17.99±1.81) pmol/L, and the thyrotropin level was (4.01±0.26) pmol/L, which was significantly higher than the control group (0.19±0.06) pmol/L, the difference was statistically significant (t=21.809 8, 101.229 8, P<0.05). After treatment, the incidence of atrial fibrillation and heart rate were 24.00%, (79.6 ±17.0) times/min, which was significantly lower than that of the control group 92.00%, (100.6±18.7) times/min, the difference was statistically significant (χ2=94.909 7, t=5.875 7, P <0.05). Conclusion The use of propylthiouracil combined with propranolol in subclinical hyperthyroidism combined with paroxysmal atrial fibrillation can effectively improve cardiac function, reduce hypothyroidism and atrial fibrillation, and is worthy of clinical promotion.