老年慢性心力衰竭并亚临床甲减应用小剂量左旋甲状腺素替代治疗的临床观察  

Effects of low-dose levothyroxine on heart function in elderly chronic heart failure patients with subclinical hypothyroidism

作　　者：吴济荫[1] 杨琳[1] 王琳[1] 乔成栋[1] 刘永铭[1] 杨京港[1] 王金羊[1] 刘艳英[1] 税莉[1] 褚慧洁[1] 

机构地区：[1]兰州大学第一医院老年病科,甘肃兰州730000

出　　处：《兰州大学学报（医学版）》2011年第2期51-54,共4页Journal of Lanzhou University（Medical Sciences）

摘　　要：目的探讨小剂量左旋甲状腺素对老年慢性心力衰竭并亚临床甲减心功能的影响。方法18例老年慢性心力衰竭并亚临床甲减患者,从12.5μg/d开始予口服左旋甲状腺素,缓慢增加剂量,使血清促甲状腺素介于4～6mIU/L,观察1年。结果服药12月时与服药前比较,超声心动图检查左室舒张末内径、左室收缩末内径明显缩小,射血分数明显增加,差异有显著性;服药6、12月与治疗前比较,室速、室性早搏均明显减少,差异有统计学意义;血压、心率无明显变化。结论小剂量左旋甲状腺素能明显改善老年心衰并亚临床甲减患者的心功能,增加射血分数,减少室速、室性早搏的发生。Objective To investigate the effects of L-thyroxine on heart function in elderly chronic heart failure patients with subclinical hypothyroidism.Methods 18 elderly patients with chronic heart failure and subclinical hypothyroidism were enrolled in the study,16 men and 2 women. They were administered L-thyroxine 12.5μg/d orally,and the dose was increased slowly based on the standard of thyroid stimulating hormone from 4 to 6 mIU/L.Treatment effects appeared after 3 months,and better effects after 6 months.Results Compared with the baseline,left ventricular end diastolic diameter（LVEDD）and left ventricular end systolic diameter（LVESD）were reduced significantly while left ventricular ejection fraction（LVEF）increased significantly after 12 months.6 months verse baseline,12 months verse 6 months,LVEDD and LVESD decreased and LVEF increased without statistical significance.6 months,12 months compared with the baseline, ventricular tachycardia and premature ventricular contractions were significantly reduced, with statistical significance.There was no significant change in blood pressure and heart rate. Conclusion Low-dose L-thyroxine can improve the heart function,increase ejection fraction and reduce the incidence of ventricular tachycardia and premature ventricular contractions in elderly chronic heart failure patients with subclinical hypothyroidism.

关 键 词：老年 心力衰竭 亚临床甲减 左旋甲状腺素 心功能 

分 类 号：R541.6[医药卫生—心血管疾病]