苯那普利对充血性心力衰竭患者甲状腺功能状态的影响

The Effect of Benazepril on Thyroid Function Status in the Patients with Congestive Heart Failure

目的:研究充血性心力衰竭(CHF)患者血清甲状腺激素水平的变化及苯那普利治疗对其的影响。方法:将106例充血性心力衰竭患者随机分成治疗组(n=56例)和对照组(n=50),治疗组采用基础治疗加苯那普利5mg^10mg/d;而对照组采用基础治疗加用安慰剂。两组疗程均为4周。观察治疗前后血清T3、T4、FT3、FT4、rT3、TSH等指标和临床疗效、左室射血分数(LVEF)、心输出量(CO)、X线心胸比、6分钟步行试验、心率等的变化。结果:充血性心力衰竭患者血清T3、FT3及T3/rT3明显下降,rT3明显升高而T4、FT4、TSH无明显变化;随着抗心衰治疗后心功能好转,两组患者临床症状改善、血中原已下降的T3、FT3明显回升而rT3明显下降,T3/rT3升高,对照组有改变(P<0.05),治疗组明显改善(P<0.01)。结论:苯那普利能有效治疗CHF及改善其血清甲状腺激素水平状况。

Objective： To observe the effect of benazepril on throidial function and cardiac function in the patients with congestive heart failure（CHF） . Method： 106 patients with CHF were divided randomly into control group （ n = 50 ） and treatment group （ n = 56 ）. Benazepril was given additionally while digoxin hydrochlorothiazide （ HCT ） , 10% pot - chloride or vessel dilator was given individually in both of two groups. The treatment of both Groups were lasting for four weeks . Before and after treatment symptoms related to CHF were observed , cardiac function parameters were measured and serum thyroid function status were determined by radioimmunoassay（RIA）. Result：The serum T3. FT3, T/rT3 was decreased significandy and rT3 was increased signitlcandy; T4 , FT4 ,TSH did not change in the 106 patients before treatment. After four weeks treatment, the clinical status became better. The total clinical effective rate in treatment group was （ 81. 9%. ） compared with （ 56.6%, ） in control group （ P 〈 0.05 ）. The serum T3, FT3, T/rT3 was increased significantly and rT3 was decreased significantly . T4, FT4, TSH had no change. Cardiac function were improved significantly（ P 〈0.05 - 0.01 ） in the two groups. Conclusion： Benazepril has a good therapeutic effect on patients with CHF. It also could significantly raise the serum T3 , FT3 ,T3/rT3 and lower the serum rT3.