小剂量甲状腺素治疗慢性心衰疗效观察

The Curative Effect of Low Doses of Thyroxine in the Treatment of Chronic Heart Failure

目的探讨小剂量甲状腺素(优甲乐)对慢性心衰治疗的效果。方法将60例慢性难治性心衰合并低T3综合征患者随机分成常规组与对照组各30例,两组均给予抗心衰常规治疗,对照组加用小剂量甲状腺素(优甲乐)。治疗后观察患者甲状腺素水平、心脏超声心动图指标、6min步行实验及心功能分级。结果对照组经治疗后血清总三碘甲状腺原氨酸(T3)、游离三碘甲状腺原氨酸(FT3),总甲状腺素(T4)、游离甲状腺素(FT4)均较治疗前明显升高(P<0.05),而促甲状腺素(TSH)治疗前后差异无显著性(P>0.05),两组均未见甲状腺中毒表现。治疗组治疗后的LVDd,E/A,LVEF,心功能分级及6min步行实验与治疗前及对照组治疗后比较均有明显改善,差异均有显著性(P<0.05)。结论慢性心衰伴低T3综合征患者经小剂量甲状腺素治疗,对心功能具有明显改善作用,未发现明显不良反应。

Objective To observe the effect of low closes of thyroid hormone in treatment of patients with chronic heart failure. Methods Sixty cases of chronic refractory heart failure with low T3. syndrome were randomly divided into the routine group（ n = 30 } and the control group（ n = 30 ） , the two groups were both given the conventional treatment of anti heart failure,in addition,the control group was given a low dose of thyroid hormone. The level of thyroid hormone,echocardiography,6min walking test and cardiac function classification were ob- served after treatment. Results In the control group ＇after treatment, serum total three iodine thyroid original glycine （ T3 ） , three free iodine thyroid former glycine （ FT3 ） , total thyroxine （ T4 ） and free thyroxine （ FT4 ） increased significantly than before treatment （ P 〈 0.05 ） , while the thyroid stimulating hormone（TSH） had no significant difference before and ＇after treatment（ P 〉 0.05） ,the two groups were not seen thy- rotoxicosis. After treatment,the LVDd,E/A,LVEF and grade of cardiac function and 6min walking test of treatment group were obviously im- proved compared with before treatment and the control group after the treatment, the differences were statistically significant （ P 〈 0.05 ）. Con- clusion Low doses of thyroid hormone treatment can significantly improve cardiac function in the patients with chronic heart failure and low 33 syndrome without obvious adverse reactions.