小剂量磷酸肌酸钠联合甲状腺素治疗甲状腺功能减退性心脏病的临床疗效研究

Clinical Effect of Small-dose Creatine Phosphate Sodium Combined with Thyroxine on Hypothyroid Heart Disease

目的探究小剂量磷酸肌酸钠联合甲状腺素治疗甲状腺功能减退性心脏病的临床疗效。方法选取2012年1月—2014年10月广州市增城区人民医院收治的80例甲状腺功能减退性心脏病患者,按照治疗方案不同分为对照组和观察组,每组40例。对照组患者给予甲状腺素口服治疗,观察组在对照组基础上联合小剂量磷酸肌酸钠治疗;两组患者均治疗10 d。比较两组患者临床疗效,治疗前后甲状腺功能〔游离甲状腺素(FT4)、游离三碘甲状腺原氨酸(FT3)、促甲状腺素(TSH)〕及心功能〔左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、心率(HR)〕。结果观察组患者临床疗效优于对照组(u=5.322,P<0.05)。治疗前两组患者血清FT4、FT3、TSH水平比较,差异无统计学意义(P>0.05);治疗后观察组患者血清FT4、FT3水平高于对照组,血清TSH水平低于对照组(P<0.05)。治疗前两组患者LVEF、LVEDD、LVESD、HR比较,差异无统计学意义(P>0.05);治疗后观察组患者LVEF高于对照组,LVEDD、LVESD、HR低于对照组(P<0.05)。结论小剂量磷酸肌酸钠联合甲状腺素治疗甲状腺功能减退性心脏病的临床疗效确切,能有效改善患者甲状腺功能及心功能。

Objective To explore the clinical effect of small-dose creatine phosphate sodium combined with thyroxine on hypothyroid heart disease. Methods A total of 80 patients with hypothyroid heart disease were selected in the People′s Hospital of Zengcheng District of Guangzhou from January 2012 to October 2014,and they were divided into control group and observation group according to therapeutic regimens,each of 40 cases. Patients of control group were given oral thyroxine,while patients of observation group were given oral thyroxine and intravenous drip of small -dose creatine phosphate sodium, both groups treated for 10 days. Clinical effect,thyroid function index（including serum levels of FT4,FT3 and TSH）and cardiac function index（including LVEF,LVEDD,LVESD and HR）were compared between the two groups. Results The clinical effect of observation group was statistically significantly better than that of control group（u=5. 322,P〈0. 05）. No statistically significant differences of serum levels of FT4,FT3 or TSH was found between the two groups before treatment（P〉0. 05）;after treatment,serum levels of FT4 and FT3 of observation group were statistically significantly higher than those of control group, while serum TSH level of observation group was statistically significantly lower than that of control group （ P〈0. 05 ）. No statistically significant differences of LVEF,LVEDD,LVESD or HR was found between the two groups before treatment（ P〉0. 05）;after treatment, LVEF of observation group was statistically significantly higher than that of control group, while LVEDD,LVESD and HR of observation group were statistically significantly lower than those of control group （ P〈0. 05 ）. Conclusion Small-dose creatine phosphate sodium combined with thyroxine has certain clinical effect in treating hypothyroid heart disease,can effectively improve the thyroid function and cardiac function.