左甲状腺素钠片联合厄贝沙坦氢氯噻嗪治疗重症心力衰竭的效果及对心功能、血流动力学的影响

Effect of Levothyroxine Sodium Tablets Combined with Irbesartan Hydrochlorothiazide in the Treatment of Severe Heart Failure and its Effect on Cardiac Function and Hemodynamics

目的研究左甲状腺素钠片联合厄贝沙坦氢氯噻嗪(IBST/HCZ)治疗重症心力衰竭(SHF)的效果及对心功能、血流动力学的影响。方法以2019年12月-2022年12月石城县人民医院收治的60例SHF患者为研究对象,采用随机数字表法分为对照组(30例)与观察组(30例),对照组给予IBST/HCZ治疗,观察组在其基础上联合左甲状腺素钠片治疗,比较两组临床疗效、心功能[左室射血分数(LVEF)、左室收缩末期内径(LVESD)、左室舒张末期内径(LVEDD)]、血流动力学[中心静脉压(CVP)、平均动脉压(MAP)]、主要不良心血管事件(MACE)、心力衰竭症状状态问卷(SSQ-HF)、明尼苏达心力衰竭生活质量(MLHFQ)评分。结果观察组治疗总有效率为96.67%,高于对照组的83.33%(P<0.05);两组治疗后LVEF大于治疗前,LVESD、LVEDD小于治疗前,且观察组LVEF大于对照组,LVESD、LVEDD小于对照组(P<0.05);两组治疗后CVP高于治疗前,MAP低于治疗前,且观察组CVP高于对照组,MAP低于对照组(P<0.05);观察组MACE发生率为6.67%,低于对照组的26.67%(P<0.05);两组治疗后SSQ-HF、MLHFQ评分均低于治疗前,且观察组SSQ-HF、MLHFQ评分低于对照组(P<0.05)。结论左甲状腺素钠片联合IBST/HCZ治疗SHF的效果良好,可改善患者心功能与血流动力学水平,降低MACE风险,减轻心衰症状,进而提升患者生活质量。

Objective To study the effect of levothyroxine sodium tablets combined with irbesartan hydrochlorothiazide(IBST/HCZ)in the treatment of severe heart failure(SHF)and its effect on cardiac function and hemodynamics.Methods Sixty patients with SHF admitted to Shicheng County People's Hospital from December 2019 to December 2022 were randomly divided into control group(30 patients)and observation group(30 patients).The control group was treated with IBST/HCZ,and the observation group was treated with levothyroxine sodium tablets on the basis of IBST/HCZ.The clinical efficacy,cardiac function[left ventricular ejection fraction(LVEF),left ventricular end-systolic diameter(LVESD),left ventricular end-diastolic diameter(LVEDD)],hemodynamics[central venous pressure(CVP),mean arterial pressure(MAP)],major adverse cardiovascular events(MACE),heart failure symptom status questionnaire(SSQ-HF),Minnesota heart failure quality of life(MLHFQ)score were compared between the two groups.Results The total effective rate of treatment in the observation group was 96.67%,which was higher than 83.33%in the control group(P<0.05).After treatment,LVEF in the two groups was larger than that before treatment,LVESD and LVEDD were smaller than those before treatment,and LVEF in the observation group was larger than that in the control group,LVESD and LVEDD were smaller than those in the control group(P<0.05).After treatment,CVP in the two groups was higher than that before treatment,MAP was lower than that before treatment,and CVP in the observation group was higher than that in the control group,MAP was lower than that in the control group(P<0.05).The incidence of MACE in the observation group was 6.67%,which was lower than 26.67%in the control group(P<0.05).After treatment,the SSQ-HF and MLHFQ scores of the two groups were lower than those before treatment,and the SSQ-HF and MLHFQ scores of the observation group were lower than those of the control group(P<0.05).Conclusion Levothyroxine sodium tablets combined with IBST/HCZ is effective in the treatment of SHF,which can improve the cardiac function and hemodynamics of patients,reduce the risk of MACE,alleviate the symptoms of heart failure,and improve the quality of life of patients.