甲状腺激素治疗难治性心力衰竭伴低T_3、低T_4综合征

Treatment of intractable heart failure accompanying by low T_3 syndrome and low T_4 syndrome with thyroxine

目的探讨在常规抗心力衰竭(心衰,CHF)基础上加用甲状腺素治疗难治性心力衰竭伴低T3、低T4综合征患者的临床疗效。方法 76例难治性心衰伴低T3、低T4综合征患者,随机分为常规治疗组与常规治疗+甲状腺素组(甲状腺素组),每组均为38例,另选取同期健康体检受试者38例作为正常对照组。常规治疗组使用常规抗心衰治疗措施,甲状腺素组在常规抗心衰治疗措施的基础上加用中小剂量甲状腺素20～60mg/d,治疗3周后分析治疗前后血清甲状腺素水平及心功能变化的情况。正常对照组不进行药物干预。结果难治性心衰患者甲状腺激素水平低于正常对照组,药物干预治疗后,两组患者血清甲状腺激素水平及心功能均有明显提高,加用甲状腺素组患者血清甲状腺激素水平及心功能的改善更为显著。结论中小剂量甲状腺素治疗难治性心衰伴低T3、低T4综合征患者有一定的疗效。

Objective To investigate the curative effect of routine heart therapy for failure combined with thyroxine in the patients with refractory heart failure accompanied by low T3 syndrome and low T4 syndrome.Methods All 76 patients were randomly divided into the routine treatment group （routine group） and routine treatment combined with thyroxine group （thyroxine group,each n=38）.Other 30 health cases were included into the normal control group.The routine group was given routine therapy for heart failure and the thyroxine group was given thyroxine in middle dose and low dose （20 mg/d to 60 mg/d） on the base of routine therapy for heart failure.After 3 weeks the level of serum thyroxine and changes of heart function were analysed before and after treatment.The normal control group was not intervened by medicinal.Results The level of serum thyroxine was lower in the patients with refractory heart failure than that in the normal cases.After medicinal intervention,the level of serum thyroxine and heart function were all improved significantly in two groups,but more significant in the thyroxine group.Conclusion Thyroxine in middle dose and low dose had relative curative effect on refractory heart failure accompanied by low T3 syndrome and low T4 syndrome.