小剂量甲状腺素对老年重症心力衰竭疗效观察

Observation of the Effects of Low Dasage L Thyroxin on the Aged Critical Congestive Heart Failure

目的 :探讨小剂量甲状腺素在老年重症心力衰竭 (CHF)中的临床疗效。方法 :测定 84例 CHF患者血清甲状腺激素 (T3、T4 、r T3、h TSH)、心率 (HR)、左室射血分数 (EF)、每分输出量 (CO)及室壁增厚率 (PWTF) ,并按心功能( 、 、 级 )情况分为 A组 (2 0例 ) ,B组 (38例 ) ,C组 (2 6例 ) ;在常规抗心衰治疗基础上给予小剂量 L- T4 治疗 ,观察治疗前后临床疗效 T3、T4 、r T3、h TSH、EF、CO及其变化。结果 :A、B、C3组治疗前 T3明显下降 ,A、B、C3组治疗前 r T3均明显升高。A组临床有效 80 % ,无效 2 0 % ;B组临床显效 2 6 .32 % ,有效 5 0 % ,无效 2 3.6 8% ;C组临床显效 15 .39% ,有效5 3.85 % ,无效 30 .77%。治疗前后比较 :3组患者的 T3较治疗前升高。 A组 CO升高 (P<0 .0 5 ) ;B组 r T3下降 (P<0 .0 5 ) ,EF升高 (P<0 .0 5 ) ,室壁增厚率提高 (P<0 .0 5 ) ;C组 r T3下降 (P<0 .0 5 ) ,EF升高 (P<0 .0 5 ) ,CO升高 (P<0 .0 5 )。结论 :小剂量甲状腺素在老年重症 CHF治疗中有一定作用。

Objective:To observe clinical effects of low dose L-thyroxin on the aged critical congestive heart failure(CHF).Methods:A total of 84 aged patients with CHF were enrolled in the study. Plasma levels of T 3,T 4,rT 3,hTSH were measured and heart rate(HR)was examined. Echocardiogram was performed to evaluate EF, CO, PWTF The patients were divided into A (20 case), B(38 care), C (26 care) group by level Ⅱ,Ⅲ,Ⅳ heart function; All the patients were assigned to be administered low dose L-thyroxin besides general treatment. Clinical signs and symptoms of hyperthyroidism were recorded before and after treatment. Every patient was measured plasma levels of T 3, T 4, rT 3 , hTSH. Echocardiogram was conducted to evaluate EF,CO, and PWTF.Result:All patients had no clinical sign and symptoms of hyperthyroidism, and plasma T 3 level was obviously lower but plasma rT 3 level obviously higher before treatment. Clinical effective rate in group A was 80%. In group B, clinical obviously effective rate was 26.32% ,clinical effective rate was50%; In group C, clinical obviously effective rate was15.39%, clinical effective rate was 53.85%. Plasma level of T 3 was increased after treatment in three groups compared with before treatment. CO was found increased in group A after treatment (P<0.05) by echocardiogram; plasma level of rT 3 was reduced (P<0.05) in group B and C. EF, PWTF were found increased (P<0.05) by echocardiogram in group B. EF, CO were found increased (P<0.05)by Echocardiogram in group C.Conclusion:Administration of low close L-thyroxin might be helpful to the aged critical patients with CHF.