曲美他嗪联合左甲状腺素钠对甲状腺功能减退性心脏病患者心功能的影响

Effects of trimetazidine combined with levothyroxine on the cardiac function in the patients with hypothyroid heart disease

目的研究曲美他嗪联合左甲状腺素钠对甲状腺功能减退性心脏病(甲减性心脏病)患者心功能的影响。方法 84例甲减性心脏病患者随机分为2组:观察组42例使用曲美他嗪联合左甲状腺素钠治疗;对照组42例使用左甲状腺素钠治疗。2组分别在治疗前、治疗后2个月检测甲状腺功能(FT_3、FT_4、TSH)、左室射血分数(LVEF)、左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD),并进行6 min步行距离测试,评价治疗效果。结果治疗后,观察组总有效率为88.10%(37/42),高于对照组的59.52%(25/42),差异有统计学意义(P<0.05);与治疗前比较,治疗后2组FT_3、FT_4、TSH、LVEF、LVEDD、LVESD及6 min步行距离等指标均有明显改善(P<0.05),且观察组较对照组改善更明显(P<0.05)。结论曲美他嗪联合左甲状腺素钠治疗甲减性心脏病,可以明显改善心功能,安全有效。

Objective To explore the effects of trimetazidine combined with levothyroxine on the cardiac function in the patients with hypothyroid heart disease .Methods 84 cases of hypothyroidism heart disease were randomly divided into two groups： 42 cases in the observation group , used of trimetazidine and levothyroxine sodium for therapy ; 42 cases in the control group, used of levothyroxine sodium for therapy .2 groups at baseline, after 2 months of treatment, thyroid function （FT3 , FT4 , TSH）, left ventricular ejection fraction （LVEF）, left ventricular end-diastolic diameter （LVEDD）, left ventricular sys-tolic diameter （LVESD）, and 6 min walking distance were tested, evaluate the therapeutic effect .Results After treatment, the total effective rate of observation group was 88.10% （37 /42） which is higher than 59.52% （25 /42） in control group, the difference was statistically significant （ P ＆lt;0.05）; compared with before treatment , 2 groups＆#39;FT3 , FT4 , TSH, LVEF, LVEDD, LVESD and 6 min walk distance were significantly improved after treatment （ P ＆lt;0.05）, and the more obvious im-provements in the observation group （ P ＆lt;0.05） was found.Conclusion Trimetazidine combined with levothyroxine in the patients with hypothyroid heart disease can significantly improve the cardiac function , shorten the period of treatment , which is safe and effective.