| 盛云峰.含丙硫异烟胺和对氨基水杨酸治疗方案致甲状腺功能减退的临床分析[J].浙江中西医结合杂志,2016,26(6): |
| 含丙硫异烟胺和对氨基水杨酸治疗方案致甲状腺功能减退的临床分析 |
| Clinical analysis of hypothyroidism induced by protionamide and para-aminosalicylic acid |
| 投稿时间：2015-10-20 修订日期：2016-01-30 |
| DOI： |
| 中文关键词: 甲状腺功能减退 丙硫异烟胺 对氨基水杨酸 临床分析 |
| 英文关键词:hypothyroidism protionamide para-aminosalicylic acid clinical analysis |
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| 中文摘要: |
| 目的：分析含丙硫异烟胺(Pto)和对氨基水杨酸(PAS)方案治疗耐多药肺结核(MDR—TB)致甲状腺功能减退(甲减)的发生情况，探讨应用Pto和PAS导致药物性甲减的处理方法和措施。方法：对2010年1月至2015年1月就诊于浙江省结核病诊疗中心的耐多药肺结核患者采取含Pto和（或）PAS的方案治疗，应用回顾性分析对甲减时的性别、年龄、发生时间、临床表现及治疗转归等进行研究。结果：治疗520例MDR-TB患者，发生甲减118例(22.7％，118/520)；男性发生率为19.5％(73／374)，女性发生率为30.8％(45／146)，男女之间比较，差异有统计学意义(?2 =7.648，P<0.05)。不同药物组合方案中Pto联合PAS方案组的甲减发生率31.4%，高于含Pto组（16.1%）和PAS组(18%)，差异有统计学意义（?2 =15.025，P<0.05）。甲减发生时间主要位于治疗后的前6个月（77.1%）。以轻度甲减为主（66.9%）。结论：应用含Pto和（或）PAS方案治疗MDR-TB时应注意甲减的发生，尤其对于女性和Pto联合PAS治疗的患者。早期和全程监测甲状腺功能，有利于及早发现和治疗甲减。使用L-T4替代治疗能控制甲减，避免了治疗中断。 |
| 英文摘要: |
| Objectiv To investigate the frequency and clinical characteristics associated with hypothyroidism induced by protionamide and para-aminosalicylic acid in multi-drug resistant tuberculosis(MDR-TB),and provide the preventive methods and regimen for the patients with hypothyroidism caused by Pto and PAS. Methods A retrospective analysis was performed for the MDR-TB patients treated with regimen containing Pto and/or PAS in Tuberculosis Diagnosis and Treatment Center of Zhejiang during Jan.2010 and Jan.2015.We analyzed the associated factors for the cases with hypothyroidism, including age, gender, time of onset, severity and prognosis. Results A total of 520 cases were admitted, and 118 cases were diagnosed hypothyroidism, resulting in an incidence of 22.7％(118/520),being 19.5％ in males, and 30.8％ in females(?2 =7.648，P<0.05).Cases treated by combination of Pto and PAS resulted in the highest rate of hypothyroidism(31.4%),compared with the rate of single-use Pto and PAS,16.1% and 18%,perspectively(P<0.05).About 77.1% of cases was diagnosed with hypothyroidism at 6 months, and mild hypothyroidism patients accounted for 66.9%. Conclusions Hypothyroidism induced by Pto and PAS should be taken seriously, especially in females and for the combination therapy. The early monitering thyroid function within the entire treatment is in favor of detection and treatment of hypothyroidism. Taking the L-T4 can control the hypothyroidism. |
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