左甲状腺素治疗亚临床甲状腺功能减退症伴心血管疾病患者的疗效观察

Therapeutic effect of L-thyroxine on patients with subclinical hypothyroidism and cardiovascular disease

目的评价左甲状腺素治疗对亚临床甲状腺功能减退症(亚临床甲减)伴心血管疾病患者的临床效果。方法60例亚临床甲减伴心血管疾病患者,随机分为对照组及观察组,各30例。对照组患者采取基础对症治疗,观察组患者给予基础对症治疗联合左甲状腺素治疗。比较两组患者治疗前后的血脂指标、甲状腺功能指标、心功能指标水平。结果治疗后,两组患者的总胆固醇、低密度脂蛋白胆固醇、甘油三酯水平均低于本组治疗前,高密度脂蛋白胆固醇水平高于本组治疗前,且观察组患者的总胆固醇(3.80±0.35)mmol/L、低密度脂蛋白胆固醇(2.53±0.10)mmol/L、甘油三酯(1.22±0.06)mmol/L均低于对照组的(4.70±0.40)、(3.15±0.13)、(1.72±0.10)mmol/L,高密度脂蛋白胆固醇(1.45±0.10)mmol/L高于对照组的(1.20±0.15)mmol/L,差异具有统计学意义(P<0.05)。治疗后,两组患者的促甲状腺激素、左室射血分数、心功能分级、6 min步行距离均较本组治疗前改善,且观察组改善幅度大于对照组,差异均具有统计学意义(P<0.05)。结论左甲状腺素治疗亚临床甲减可以促进患者血脂代谢改善,对心血管有保护作用,治疗预后效果佳。

Objective To evaluate the clinical effect of L-thyroxine on patients with subclinical hypothyroidism and cardiovascular disease.Methods 60 patients with subclinical hypothyroidism and cardiovascular disease were randomly divided into a control group and an observation group,with 30 patients in each group.Patients in the control group were treated with basic symptomatic treatment,while patients in the observation group were treated with basic symptomatic treatment combined with L-thyroxine.Levels of blood lipid indexes,thyroid function index,cardiac function index prior and after treatment were compared between these two groups.Results The levels of total cholesterol,low-density lipoprotein cholesterol,triglyceride of patients in these two groups after treatment were lower than those prior treatment;the level of high-density lipoprotein cholesterol of patients in these two groups after treatment was higher than that prior treatment.Further,patients in the observation group had total cholesterol of(3.80±0.35)mmol/L,low-density lipoprotein cholesterol of(2.53±0.10)mmol/L,triglyceride of(1.22±0.06)mmol/L,which were lower than(4.70±0.40)mmol/L,(3.15±0.13)mmol/L,(1.72±0.10)mmol/L of patients in the control group;patients in the observation group had high-density lipoprotein cholesterol of(1.45±0.10)mmol/L,which was higher than(1.20±0.15)mmol/L of patients in the control group;all the difference was statistically significant(P<0.05).The thyroid stimulating hormone,left ventricular ejection fraction,cardiac function classification and 6 min walking distance of these two groups after treatment were improved,compared with those prior treatment;and the improvements in the observation group were greater than those in the control group;all the difference was statistically significant(P<0.05).Conclusion L-thyroxine in the treatment of subclinical hypothyroidism can promote the improvement of blood lipid metabolism,protect the cardiovascular system,and have a good prognosis.