小剂量左旋甲状腺素治疗扩张性心肌病伴甲状腺功能正常的病态综合征疗效观察

Therapeutic value of low dose L-thyroxine on patients with dialated cardiomyopathy and refractory heart failure

目的探讨小剂量左旋甲状腺辅助治疗扩张性心肌病合并顽固性心力衰竭的疗效及可能作用机制。方法入选因扩张性心肌病难治性心力衰竭同时合并有甲状腺功能正常的病态综合征在本院心内科住院的患者共110例,随机分为小剂量左旋甲状腺治疗组及常规治疗组各55例,比较两组治疗效果。结果两组心率均较治疗前减慢,治疗组减慢更明显,较对照组减慢5次以上,差异有统计学意义;饮食、精神、6m in步行距离,治疗组均较对照组改善明显、迅速;住院时间明显缩短,差异有统计学意义;12周时,左室射血分数治疗组较对照组改善明显,差异有统计学意义;28周时,左室射学分数和左室大小,治疗组较对照组均改善明显,差异有统计学意义。结论小剂量左旋甲状腺素治疗扩张性心肌病伴甲状腺功能正常的病态综合征有效。

Objective To study the clinical therapeutic effect and mechanisms of low dose L-thyroxine on dialated cardiomyopathy accompanied by refractory heart failure.Methods 110patients of dialated cardiomyopathy accompanied by refractory heart failure and thyroxine euthyroid sick syndromewere randomly divided into two groups,low dose L-thyroxine treated group（55patients） and generally treatment group（55patients）.The treatment group used low compare the therapeutic effect.Results Heart rates decline significantly in two groups at the end of the study.Therapy groups,more obvious slow down the five above statistics,there are differences in meaning.Diet、 spirit and 6MWT improved greatly and rapidly in the low dose L-thyroxine treated group,the duration of hospitalization were shortened significantly in the low dose L-thyroxine treated group,there are differences in meaning.LV ejection fraction（LVEF） improved significantly in two group s at the end of 12 weeks study.The treatment group improved much more（P0.05）.LV ejection fraction（LVEF） and LVD improved significantly in two groups at the end of study.The treatment group improved much more（P0.05）.Conclusion Low dose L-thyroxine for dilated cardiomyopathy accompanied by refractory heart failure and thyroxine euthyroid sick syndromewere effective.