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目的观察131I联合他巴唑治疗Graves甲状腺功能亢进(甲亢)并心房颤动(房颤)的临床疗效。方法 76例Graves甲亢并房颤患者随机分为A组32例(病程≤1a者14例为A1组,病程>1a者18例为A2组),B组44例(病程≤1a者21例为B1组,病程>1a者23例为B2组),A组给予他巴唑口服,B组他巴唑用法、用量同A组,并给予131I治疗,1a后评定2组甲亢和房颤治疗有效率,并比较2组甲状腺功能减退发生率。结果 A组甲亢治愈率、总有效率和房颤缓解率分别为40.6%,75.0%和46.9%;B组分别为79.5%,95.5%和75.0%,2组比较差异均有统计学意义(P<0.01,或P<0.05),其中A1组房颤缓解率(31.2%)高于A2组(15.6%)(P<0.01),B1组房颤缓解率(43.2%)高于B2组(31.2%)(P<0.05);治疗过程中A组发生白细胞减少5例,肝功能损害7例,B组均未发生;2组不良反应发生率比较差异有统计学意义(P<0.05)。结论 131I联合他巴唑治疗Graves病甲亢并房颤疗效优于单纯他巴唑治疗。
Objective To observe the clinical efficacy of 131I combined with itpazole in the treatment of Graves’ hyperthyroidism and atrial fibrillation (atrial fibrillation). Methods A total of 76 patients with Graves hyperthyroidism and atrial fibrillation were randomly divided into group A (n = 32), group A (n = 14), group A (n = 14), group B B1 group, duration of> 1a in 23 cases for the B2 group), group A was given methimazole, group B methimazole dose, with the same amount of group A, and given 131I treatment, after 1 year assessment of hyperthyroidism and AF treatment of two groups of Efficiency, and compared the incidence of hypothyroidism in two groups. Results The cure rate, the total effective rate and the remission rate of atrial fibrillation in group A were 40.6%, 75.0% and 46.9%, respectively, while those in group B were 79.5%, 95.5% and 75.0%, respectively (31.2%) in group A1 was higher than that in group A2 (15.6%) (P <0.01). The rate of atrial fibrillation in group B1 was higher than that in group B2 %) (P <0.05). There were 5 cases of leukopenia in A group and 7 cases of hepatic dysfunction in treatment group, all of which did not occur in group B; There was significant difference in the incidence of adverse reactions between the two groups (P <0.05). Conclusion 131I combined with itpazole treatment of Graves disease hyperthyroidism and atrial fibrillation superior to metronidazole alone treatment.