A Clinical Study Of Treatment On Newly Diagnosed Graves' Disease Patient With Mild Leukopenia Or Liver Function Impairment

Objective: To investigate whether the onset of Graves' disease combined with mild leukopenia or liver damage requires the combined use of leukocyte-raising drugs or liver-protective drugs.Methods: Clinical data and follow-up data of 187 patients who were diagnosed with primary Graves disease with leukocytopenia or liver function impairment and were not treated with drugs in the Endocrinology Department of Changde First People's Hospital from January 2017 to January 2020 retrospective analysis was performed.Patients with leukopenia were divided into anti-thyroid drug group(A total of 44 people,only treated with antithyroid drugs),leukocyte-raising group(A total of 15 people,only given leukocyte ascending drug treatment)and anti-thyroid drug combined leukocyte-raising group(A total of 40 people were treated with antithyroid drugs combined with leukocyte-enhancing drugs),and patients with liver function impairment were divided into anti-thyroid drug group(A total of39 people,only treated with antithyroid drugs),liver protection group(Atotal of 12 people,only liver drug treatment)and anti-thyroid drug combined liver protection group(A total of 37 people were treated with antithyroid drugs and liver protection drugs).Observe the changes of white blood cell or liver function of patients in each group,and compare whether there is a significant difference in efficacy between patients in each group.Results: 1.After 12 weeks of antithyroid drug treatment,129 patients with hyperthyroidism were effectively controlled.There was no statistically significant difference in the efficacy of hyperthyroidism treatment between the antithyroid drug group and the antithyroid drug combined with leukocyte-raising drug group(?2=0.093,P=0.761),There was no statistically significant difference in the efficacy of hyperthyroidism between the antithyroid drug group and the antithyroid drug combined with liver protection drug group(?2=0.04,P=0.841)?2.Comparison of treatment cost between antithyroid drugs group and antithyroid drugs combined with leukocyte-raising drug group :76.85±13.38(yuan)vs 328.82±51.04(yuan),P<0.01;comparison of cost-effective ratio:0.98±0.23 vs 4.11±0.85,P<0.01?Comparison of treatment costs between the antithyroid drug group and the antithyroid drug combined with liver protection drug group:78.64±11.02(yuan)vs547.35±83.29(yuan),P<0.01;comparison of cost-effective ratio:0.94±0.21 vs 6.34±1.37,P<0.01?3.When the treatment of hyperthyroidism is effective,the white blood cells in the antithyroid drug group and the antithyroid drug combined with leukocyte-raising drug group gradually increase.The recovery time of the two groups of white blood cells and the difference between the two groups of white blood cells at different follow-up time points are not significant,P>0.05?The alanine aminotransferase and aspartate aminotransferase in the antithyroid drug group and the antithyroid drug combined with liver protection drug group gradually decreased.The difference in liver function recovery time and liver function between the two groups at different follow-up time points was not significant,P>0.05?Conclusion: This study indicates that patients with primary Graves disease with mild leukopenia or liver function impairment can return to normal white blood cells and liver function after standard antithyroid therapy,without the need for leukocyte-raising drugs or liver-protecting drugs.