甲状腺功能亢进性心脏病应用大剂量心得安治疗的临床分析

Clinical analysis on large dosage of inderal in treatment of hyperthyroid heart disease

目的探讨心得安治疗甲状腺功能亢进性心脏病的使用剂量以及临床疗效。方法在超声心动图显示射血分数〉50％、充分利尿、强心以及扩血管治疗疗效不佳的情况下，根据患者的心率决定治疗中心得安的用量。结果心功能Ⅱ、Ⅲ、Ⅳ级者分别有5例、11例、17例，射血分数分别为（67．1±7．8慨、（65．4±6．9炀、（59．9±7．3）％。心得安的使用量分别为（35．2±2．1）mg／d、（55．1±1．9）mg／a、（58．0±2．2）mg／a。33例患者心力衰竭纠正时间为1～55d，平均（13．4±1．2）d，没有出现心力衰竭加重。结论当甲状腺功能亢进性心脏病伴心力衰竭时，运用心得安有利于纠正心力衰竭以及控制甲亢症状，当射血分数〉50％时，心得安的使用是安全的。

Objective To discuss the dosage and clinical effect of inderal in the treatment of hyperthyroid heart disease. Methods As the ejection fraction indicated by echocardiography was higher than 50%, fully diuretic, and the curative effect of cardiotonic and vasodilator treatment was poor, the dosage of inderal wad decided according to the heart rate of patients. Results There were 5, 11 and 17 cases for I] , 111 and IV cardiac function and their ejection fractions were （67.1 ~ 7.8）%, （65.4 ＋ 6.9）% and （59.9 ＋ 7.3）% respectively. The dosage of inderal was （35.2 ＋ 2.1）mg/d, （55.1 ＋ 1.9）mg/d and （58.0 ＋ 2.2）mg/d respectively. The average heart failure correction time for 33 patients was 1-55 d with average of （13.4 ＋ 1.2） days, without any aggravation of heart failure. Conclusion When the hyperthyroid heart disease is accompanied by the heart failure, the application of inderal is good for correcting the heart failure and controlling the hyperthyroid symptoms. The usage of inderal is safe when the ejection fraction is higher than 50%.