小剂量左旋甲状腺素治疗重症心力衰竭的疗效  

Long-term treatment of low dose L-thyroxin in patients with serious congestive heart failure

作　　者：陈少伟 胡佳林 

机构地区：[1]湖南省湘潭市中心医院心内科,湖南湘潭411100

出　　处：《心血管康复医学杂志》2006年第5期476-478,466,共4页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的：观察小剂量左旋甲状腺素长期治疗重症心力衰竭的疗效及可行性。方法：选择128例重症充血性心力衰竭患者，随机分为观察组和肘照组，两组抗心衰基础治疗相似，观察组加服左旋甲状腺索12．5～25mg／d，对比治疗前后心功能改善情况，6min步行试验，血清甲状腺素水平，心率变化，再住院人次，病死率和不良反应。观察6～30个月，每3个月复查相关指标。结果：两组心功能均改善，运动耐量增加，但观察明显优于治疗对照组（P〈0．05）；血清T3、T4均恢复至正常范围，但其水平观察组升高更明显（P〈0．01），两组治疗后心率，病死率无明显差异（P〉0．05）．但再住院人次，观察组较对照减少49．26％（P〈0．01）．而且观察组治疗过程无甲亢表现。结论：长期补充小剂量甲状腺素对于慢性重症心力衰竭，不仅能显著改善心功能、生活质量，而且安全。Objective： To observes the clinical effects and feasibility of long-term treatment with low-dose L—thyroxin in patients with congestive heart failure （CHF）. Methods： A total of 128 hospitalizing patients with serious CHF were randomly divided into inspective group and control group. The routine treatment of two groups was same, but the inspective group still wanted to take 12.5-25 mg L—thyroxin every day. Cardiac function, 6 minutes walk test, plasma level of thyroxin, the number of re-hospitalizing, mortality and side effect of two groups were observed before and after treatment. The observation time was 6-30 months. The relative indexes were re-examined every 3 months. Results： All patients＇ cardiac function and ability of movement increased, but those indexes of the inspective group were superior to those of control group （P〈0.05） ; All patients＇ plasma T3. T4levels recovered to normal, but the T3. T4 levels of inspective groups were higher than those of control group （P〈0.05）. The HR and mortality of two groups were no statistical difference （P〉0.05） after treatment, but re-hospitalizing rate of inspective group was lower than that of control group （P〈0.01）. Patients of inspective group had no hyperthyroidism feature during treatment. Conclusion： Administration of low dose L—thyroxin for a long time can obviously improve cardiac function and quality of life of CHF patients and is safe.

关 键 词：心力衰竭 充血性 甲状腺素 心室功能 

分 类 号：R541.61[医药卫生—心血管疾病]