Kristensen O, Andersen H H, Pallisgaard G
Lancet. 1976 Mar 20;1(7960):603-5. doi: 10.1016/s0140-6736(76)90414-1.
Of 24 patients with newly diagnosed thyrotoxicosis, 13 were randomly selected for treatment with methimazole 40 mg per day, and 11 for treatment with lithium carbonate in such doses that the serum lithium lay between 0-5 and 1-3 meq. per litre. The lithium treatment brought about a fall in serum-thyroxine iodine (T4I) of 27.0%, and in the free-thyroxine index (F.T.I.) of 38.1% after 10 days. A comparison of the two patient groups with regard to the fall in F.T.I. after 3 and 10 days showed no statistically significant difference; similarly the calculated confidence limits appeared to exclude any difference of clinical importance. 8 of the 11 patients subjected to lithium treatment had side-effects, so that the general condition, which was already affected by the hyperthyroidism, was worsened. It is concluded that lithium cannot be considered superior to thiocarbamides for the rapid control of thyrotoxicosis.
在24例新诊断的甲状腺毒症患者中,随机选择13例接受每日40毫克甲巯咪唑治疗,11例接受碳酸锂治疗,剂量控制在使血清锂浓度维持在每升0.5至1.3毫当量之间。锂治疗10天后,血清甲状腺素碘(T4I)下降了27.0%,游离甲状腺素指数(F.T.I.)下降了38.1%。对两组患者在治疗3天和10天后F.T.I.的下降情况进行比较,未发现统计学上的显著差异;同样,计算出的置信区间似乎也排除了任何具有临床意义的差异。接受锂治疗的11例患者中有8例出现了副作用,因此原本就受到甲状腺功能亢进影响的总体状况进一步恶化。得出的结论是,在快速控制甲状腺毒症方面,锂并不比硫脲类药物更具优势。