| Abstract | Purpose of the thesis: The primary aim of this thesis was to investigate the efficacy of different thyrostatic drugs, in particular propylthiouracil (PTU) and thiamazole, in the treatment of thyrotoxic crisis. The objective of the study was to find out which drug responds most quickly and to investigate how factors such as age, BMI, smoking status, gender and previous illnesses for example Graves' disease influence the treatment results. The study examined how additional therapies, including glucocorticoids, beta blockers and iodine supplements, affected the effectiveness of these treatments. Methods: The methology of this thesis included a study of a retrospective analysis of 70 patients treated for thyrotoxic crisis at the Bezirkskrankenhaus Oberfranken/Südthüringen Klinikum Coburg from 2018 to 2022. The patients were divided into two groups: those treated with PTU (32 patients) and those treated with thiamazole (38 patients). Data collection included thyroid function tests (TSH, FT3, FT4), heart rate, weight, height, smoking habits and medical history. The severity of the crisis was assessed using the Burch-Wartofsky score and statistical analyses were performed to compare the treatment outcomes of the two drug groups. Results: The study showed that PTU led to a faster normalization of thyroid hormone levels compared to thiamazole. Patients in the PTU group achieved normalization of FT3 in an average of 5.23 days and FT4 in 7.38 days. In contrast, patients in the thiamazole group required 8.18 days for FT3 normalization and 10.5 days for FT4 normalization. Independent variables were found to have a significant impact on treatment duration, with men, older patients and smokers requiring more time for hormone normalization. The study also found that 60% of the total population had pre-existing thyroid conditions. Furthermore, the study concludes that PTU causes a faster normalization of thyroid hormone levels in patients with a thyrotoxic crisis than thiamazole. The results underline the importance of individualized treatment strategies, taking into account factors such as gender, BMI, smoking status and age, to optimize patient outcomes. The study advocates for further research to understand the mechanisms behind these differences and to validate the results in larger, more diverse populations. |
| Abstract (croatian) | Svrha rada: Primarni cilj ovog rada bio je istražiti učinkovitost različitih tireostatskih lijekova, posebno propiltiouracila (PTU) i tiamazola, u liječenju tireotoksične krize. Cilj studije bio je otkriti koji lijek najbrže djeluje te istražiti kako faktori poput dobi, BMI, statusa pušenja, spola i prethodnih bolesti poput Gravesove bolesti utječu na rezultate liječenja. Također je proučeno kako dodatne terapije, uključujući glukokortikoide, beta blokatore i dodatke joda, utječu na učinkovitost ovih tretmana. Metode: Studija je uključivala retrospektivnu analizu 70 pacijenata liječenih zbog tireotoksične krize u Bezirkskrankenhaus Oberfranken/Südthüringen Klinikum Coburg od 2018. do 2022. godine. Pacijenti su podijeljeni u dvije skupine: oni liječeni s PTU (32 pacijenta) i oni liječeni s tiamazolom (38 pacijenata). Prikupljanje podataka uključivalo je testove funkcije štitnjače (TSH, FT3, FT4), srčani ritam, težinu, visinu, navike pušenja i medicinsku povijest. Ozbiljnost krize procijenjena je korištenjem Burch-Wartofsky skora, a statističke analize su provedene kako bi se usporedili rezultati liječenja dviju skupina lijekova. Rezultati: Studija je pokazala da PTU dovodi do brže normalizacije razine hormona štitnjače u usporedbi s tiamazolom. Pacijenti u PTU skupini postigli su normalizaciju FT3 u prosjeku za 5,23 dana, a FT4 za 7,38 dana. Nasuprot tome, pacijentima u tiamazol skupini bilo je potrebno 8,18 dana za normalizaciju FT3 i 10,5 dana za normalizaciju FT4. Nezavisne varijable imale su značajan utjecaj na trajanje liječenja, pri čemu su muškarci, stariji pacijenti i pušači zahtijevali više vremena za normalizaciju hormona. Studija je također utvrdila da je 60% ukupne populacije imalo prethodne bolesti štitnjače. Studija zaključuje da PTU uzrokuje bržu normalizaciju razine hormona štitnjače kod pacijenata s tireotoksičnom krizom u usporedbi s tiamazolom. Rezultati naglašavaju važnost individualiziranih strategija liječenja, uzimajući u obzir faktore poput spola, BMI, statusa pušenja i dobi, kako bi se optimizirali ishodi pacijenata. Studija zagovara daljnja istraživanja kako bi se razumjeli mehanizmi iza ovih razlika i potvrdili rezultati na većim, raznovrsnijim populacijama. |
