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《Chinese Journal of Difficult and Complicated Cases》 2017-01
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Changes in thyroid hormone and bone mineral density of elderly patients with Graves' disease in treatment with levothyroxine and methimazole

LI Zhen;OU Daoliang;LI Meihua;ZHONG Chunzheng;Department of Endocrinology,Danzhou People's Hospital;  
Objective To observe the effect of levothyroxine combined with methimazole treatment of elderly patients with Graves' disease on thyroid hormones and bone mineral density index.Methods Sixty cases of elderly patients with Graves' disease were selected,who were treated in hospital from February 2014 to February 2015,and they were divided into the study group(30 cases) and the control group(30 cases).The patients of control group were treated with methimazole tablets(2 times / day,initial dose of 20-30 mg / d,alter treatment of one month,review of thyroid function monthly,gradually reduce the dose adjustment).On the basis of control group,the patients of study group were treated with levothyruxiue(25g/d,orally,2 times / day,review of thyroid function monthly).The patients of two groups were all consecutive treated for 12 months.Compare the ihyroid function,bone biochemical markers,bone mineral density and the incidence of adverse reactions of two groups.Results After the appropriate treatment,the levels of FT_3,FT_4,TRAb,TPOAb,BGP,ALP,UP,UCa of the stud) group were significantly lower than those of the control group(t =7.705,t =1.743,t =2.783,t =1.762,t =8.625,t =10.128,t =33.495,t =8.207,t =1.730,P 0.05),the levels of TSH of the study group were significantly higher than those ol the control group(t = 1.730,P 0.05),but in the terms ol FTH,CT,there were no significant difference between the two groups(t =0.224,t =0.278,all P 0.05);The bone mineral density of femoral neck,lumbar L2-14,femoral trochanter,Ward triangle bone of the study group were significantly higher than those of the control group(t =3.701,t =3.215,t =3.277,t = 1.856,all P 0.05);There were rash,leukopenia,agranulocytosis,gastrointestinal tract,liver damage and other adverse reactions occurred in both two groups during the treatment,but there was no significant difference between the two groups(x~2 =0.712,x~2=0.529,x~2 = 1.940,x~2 =1.217,x~2 =2.420,all P0.05).Conclusion Levothyroxine combined with methimazole treatment can effectively improve the level of thyroid hormone in elderly patients with Graves' disease,increase bone density,good safety,and is worthy of clinical promotion.
【CateGory Index】: R581.1
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