小剂量甲状腺素联合厄贝沙坦氢氯噻嗪联合心理干预治疗老年重症心力衰竭的临床疗效观察

Clinical observation of low dose thyroxine combined with irbesartan and hydrochlorothiazide combined with psychological intervention in the treatment of severe heart failure in the elderly

目的研究分析小剂量甲状腺素联合厄贝沙坦氢氯噻嗪治疗老年重症心力衰竭的临床疗效。方法选取杭州市中医院2013年1月~2016年12月收治的100例老年重症心力衰竭患者作为研究对象,随机分为对照组和实验组,每组50例。对照组患者进行常规治疗,实验组患者进行小剂量甲状腺素联合厄贝沙坦氢氯噻嗪治疗联合心理干预。比较分析2组患者的临床治疗效果。结果治疗后,实验组治疗总有效率为88.0%显著高于对照组的70.0%,差异具有统计学意义（P〈0.05）。治疗后,实验组患者的左心室射血分数指标、四碘甲状腺原氨酸与三碘甲状腺原氨酸水平均显著高于治疗前,对照组患者左心室射血分数指标显著高于治疗前,差异具有统计学意义（P〈0.05）。结论小剂量甲状腺素联合厄贝沙坦氢氯噻嗪治疗老年重症心力衰竭临床效果较好,能够在一定程度上提高治疗效果,具有临床进一步推广和应用的意义。

Objective To study the clinical efficacy of low dose thyroxine combined with irbesartan hydrochlorothiazide in the treatment of elderly patients with severe heart failure. Methods 100 cases of elderly patients with severe heart failure treated in our hospital from January 2013 to December2016 were selected as the research object in this study. They were randomly divided into control group and experimental group,with 50 cases in each group. Patients in the control group were treated with conventional therapy,while the experimental group was treated with low dose thyroxine combined with irbesartan and hydrochlorothiazide. The clinical efficacy of the two group were compared and analyzed. Results After the corresponding treatment,the total effective rate of the experimental group was 88. 0%,significantly higher than that of the control group（ 70. 0%）,the difference was statistically significant（ P〈 0. 05）. After treatment,the experimental group of patients with left ventricular ejection fraction index,four triiodothyronine and three triiodothyronine levels were significantly higher than those before treatment,the control group of patients with left ventricular ejection fraction were significantly higher than before treatment,the difference was statistically significant（ P 〈0. 05）. Conclusion Low dose thyroxine combined with irbesartan hydrochlorothiazide in the treatment of elderly patients with severe heart failure has better clinical effect,can improve the therapeutic effect in a certain extent,with further clinical promotion and application significance.