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目的探讨儿童甲状腺功能亢进症的治疗措施及临床效果。方法对入选的200例儿童甲状腺功能亢进症患儿给予甲巯咪唑0.5～1.0mg/(kg·d)、盐酸普萘洛尔0.3mg/(kg·d)治疗,2～4个月待患儿甲状腺功能基本恢复正常后,将患儿随机分为对照组(n=100)及研究组(n=100)。对照组只给予甲巯咪唑治疗,研究组则继续给予甲巯咪唑并联合左甲状腺素钠治疗。比较治疗前和治疗后6个月、1年及2年患儿甲状腺体积,FT4、FT3和TSH水平,观察治疗后2年不良反应发生情况。结果与对照组比较,治疗6个月后研究组甲状腺体积明显降低(P<0.05),药物性甲状腺功能减退症发生率低(P<0.05),不良反应少。结论两种治疗措施均能有效改善儿童甲状腺功能亢进症的高代谢症候群,使FT3、FT4及TSH水平恢复正常,甲状腺体积明显降低,但甲巯咪唑联合左甲状腺素钠治疗能更安全有效地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。
Objective To investigate the treatment and clinical effect of hyperthyroidism in children. Methods 200 cases of children with hyperthyroidism were given methimazole 0.5 ~ 1.0mg / (kg · d), propranolol 0.3mg / (kg · d) treatment, 2 to 4 months to treat Children with normal thyroid function returned to normal, the children were randomly divided into control group (n = 100) and the study group (n = 100). The control group was given methimazole only, and the study group was given methimazole combined with levothyroxine sodium. Thyroid volume, FT4, FT3 and TSH levels were compared before treatment and 6 months, 1 year and 2 years after treatment, and the incidence of adverse reactions 2 years after treatment was observed. Results Compared with the control group, the volume of thyroid in the study group decreased significantly (P <0.05) and the incidence of hypothyroidism was lower (P <0.05) after 6 months of treatment, with fewer adverse reactions. Conclusions Both treatments can effectively improve the high metabolic syndrome in children with hyperthyroidism, return the levels of FT3, FT4 and TSH to normal, and significantly reduce the volume of thyroid. However, the combination of methimazole and levothyroxine can be safely and effectively controlled Goiter and drug secondary hypothyroidism, and can reduce the recurrence of symptoms.