摘要
目的 :观察小剂量甲状腺素在治疗充血性心力衰竭 (CHF)中对血清甲状腺素及心功能的影响。方法 :测定1 6 8例CHF患者血清甲状腺素 (T3 、T4、rT3 、hTSH)、左室射血分数 (EF)、每分输出量 (CO)及室壁增厚率 (PWTF) ,并按心功能 (ⅡⅢⅣ级 )情况分为A组 (4 0例 )、B组 (76例 )、C组 (5 2例 ) ;在常规抗心衰治疗的基础上给予小剂量L T4治疗 ,观察治疗前后T3 、T4、rT3 、hTSH、EF、CO的变化。结果 :治疗前 ,T3 下降、与心功能呈正相关 ,rT3 升高 ,与心功能呈负相关 ,T4、hTSH正常。治疗后 ,第 1 4天、第 30天CO、EF、PWTF明显改善 (P <0 .0 5 ) ;T3 升高、rT3 下降 (P <0 .0 5 ) ,与心功能的好转一致。结论 :CHF时伴有T3 下降、rT3 升高 ,与CHF的严重程度相关 ,在常规心衰治疗基础上加用小剂量甲状腺素 。
Objective:To observe the effects of low dose of L thyroxine on thyroxine level and cardiac function in treatment of the patients with congestive heart failure(CHF).Methods:A total of 84 patients with CHF were enrolled in the study. Plasma levels of T 3,T 4,rT 3,hTSH were measured and heart rate (HR) was examined.Echocardiogram was found to evaluate EF,CO and PWTF. The patients were divided into group A(40 cases),group B(76 cases),and group C(52 cases) by level Ⅱ,Ⅲ,Ⅳ heart function; All the patients were assigned to be administered with low dose of L thyroxine besides a general treatment. The plasma levels of T 3,T 4,rT 3,hTSH were measured in all patients.Echocardiogram was found to evaluate EF,CO,and PWTF before and after treatment. Results: Pretherapy,T 3 decreased and had a positive correlative with cardiac function;rT 3 increased and showed a negative correlative with cardiac function.In 14 days and 30 days of post treatment CO,EF,PWTF improve( P <0.05),T 3 increase,rT 3 decrease, these amelioration was correlative with cardiac function.Conclusion:CHF companion contain low T 3 and height rT 3,is related with CHF serious degree. using low dose of L thyroxine in addition of general treatment, would promote the improvement of the cardiac function in short period.
出处
《实用临床医学（江西）》
CAS
2004年第4期18-20,共3页
Practical Clinical Medicine
关键词
充血性心力衰竭
甲状腺素
心功能
congestive heart failure
L-thyroxine
cardiac function
