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1、他巴唑联合左甲状腺素治疗儿童甲状腺功能亢进症的疗效观察【摘要】目的研究他巴唑联合左甲状腺素治疗儿童甲状腺功能亢进症的临床效果。方法对入选的46例儿童甲状腺功能亢进症患儿在治疗开始给予他巴唑0.5~1mg/（kg·d）治疗，2~3个月后,当患儿甲状腺功能基本恢复正常后，将患儿随机分为MMI组（n=24）及MMI+T4组（n=22）,MMI组继续给予他巴唑治疗，MMI+T4组给予他巴唑联合左甲状腺素治疗，在治疗前、治疗后第2个月、第6个月和1年时比较患儿甲状腺体积，FT4、FT3、TSH。治疗2年后观察临床疗效及不良反应发生情况。结果治疗6个月后，MMI+T4组甲状腺体积明显降低（P＜
2、0.05），药物性甲状腺功能减退症发生率低（P＜0.05），有显著性差异，不良反应发生少。结论两组治疗均能有效改善儿童甲状腺功能亢进症的高代谢症候群，使TSH、FT4、FT3恢复正常，但他巴唑联合左甲状腺素治疗更能安全有效控制甲状腺肿大及药物继发性甲状腺功能减退症，并能减少症状复发。【关键词】儿童甲状腺功能亢进症；他巴唑联合左甲状腺素；甲状腺肿大；继发性甲状腺功能减退症Clinicalobservationofchildrenhyperthyroidismtreatedbythiamazoleandlevothyroxine8［Abstract］ObjectiveToobserve
3、theclinicaleffectofthiamazolewithlevothyroxineinthetreatmentofchildrenhyperthyroidism.Methods46patientsofchildrenhyperthyroidismweretreatedwiththiamazole［0.5~1mg/（kg·d）］inbeginning,aftertwoorthreemonths,whenthefunctionofthyroidglandofthesepatientswerenormallevel,the46casesofchildrenhyperthyroi
4、dismweredividedintwogroupsinrandom:MMIgroup（n=24）,MMI+T4group（n=22）.PatientsofMMIgroupweretreatedwiththiamazolegoingon,andpatientsofMMI+T4groupweretreatedwiththiamazoleandlevothyroxine.Thyroidgland'sphysicalvolume,FT4,FT3,TSHwerecomparedbeforetreatmentandaftertwomonths,sixmonths,oneyear,effica
5、cyandsafetywereevaluatedattwoyearsaftertreatment.ResultsSixmonthsaftertreatment,thethyroidgland'sphysicalvolumeandsecondaryhypothyradismofdrugwasmarkedlydifferentbetweenMMI+T4groupandMMIgroup（P＜0.05）,thethyroidgland'sphysicalvolumeofMMI+T4groupwasobviouslowerthanMMIgroup,theincidencerateofseco
6、ndaryhypothyradismwaslower,andevilreactionswasless.ConclusionTwosetsoftreatmentprojectallvalidlyimproveshighmetabolismsymptomsofchildrenhyperthyroism,TSH,FT4,FT3canbenormallevel.Butthiamazole8withlevothyroxinecancontrolgoiterandsecondaryhypothyroidismofdrugmoresafelyandvalidlyanddecreaseinrela
7、pse.［Keywords］childrenhyperthyroidism；thiamazolewithlevothyroxine；goiter；secondaryhypothyroidism儿童甲状腺功能亢进症是由多种原因所致甲状腺激素分泌增多伴发甲状腺肿大、突眼、基础代谢率增高等表现。近年来，儿童及青少年甲状腺功能亢进症的发病率有增长趋势［1］。自2002年1月~2005年1月，我院采用单用他巴唑或他巴唑联合左甲状腺素（优甲乐）治疗儿童甲状腺功能亢进症并进行疗效对
