充血性心力衰竭血浆甲状腺素测定的临床意义  

Clinical Significance of Determination of Plasma Thyroid Hormone in Patients with Congestive Heart Failure

作　　者：周智林[1] 郑凤鸣[1] 林玎[1] 俞娉[1] 林萍[1] 

机构地区：[1]浙江省杭州市第三人民医院,310009

出　　处：《中国误诊学杂志》2002年第4期494-496,共3页Chinese Journal of Misdiagnostics

摘　　要：目的　探讨充血性心力衰竭 (CHF)患者甲状腺激素水平的变化与 CHF的严重程度的关系及应用甲状腺素治疗的临床意义。方法　对按 NYHA心功能分级为 2～ 4级的 CHF患者 6 3例随机分为治疗组和对照组 ,其中治疗组加用甲状腺素。两组治疗前后分别测定甲状腺激素水平及左室射血分数 (L VEF)、左室短轴缩短率 (FS)、每搏出量 (SV)、心输出量 (CO)及心脏指数 (CI)。结果　治疗组治疗 2周后的显效率、总有效率分别为 5 8.1%和 10 0 % ,明显优于治疗对照组 (P<0 .0 5 )。两组治疗后 L VEF、FS、SV、CO、CI均较治疗前有明显改善 (P<0 .0 5或 0 .0 1) ,但治疗组较对照组改善更显著 (P<0 .0 5 )。治疗组和对照组的 CHF患者的 T3水平在治疗前较正常对照组降低 (P<0 .0 1) ,治疗后两组 T3水平均可回升 (P<0 .0 1或 0 .0 5 ) ,但治疗组较治疗对照组回升更显著 (P<0 .0 5 )。结论　甲状腺激素在 CHF的发生发展过程中起一定的作用。Objective To investigate the relationship between alteration of thyroid hormone and severity of congestive heart failure (CHF) and clinical significance of treatment of thyroid hormone in patients with CHF.Methods 63 patients suffering from CHF with their cardiac function between level 2 to 4 according to NYHA were randomly divided into experimental and control group, and thyroid hormone was given to the experimental group for 2 weeks. Thyroid hormone level,ejection fraction of left ventricle (LVEF),fractional shortening of left ventricle (FS),stroke volume (SV),cardiac output(CO) and cardiac index(CI) were determined before and after treatment.Results Significant efficacy and overall efficacy for experimental group were 58.1% and 100% respectively after two weeks′ treatment, significantly higher than those in control group (P<0.05).LVEF?FS?SV?CO and CI of two group improved significantly after treatment compared with those before treatment(P<0.05 or 0.01),but they improved more significantly in experimental group than in control group(P<0.05).T 3 levels in both groups were lower than in normal group before treatment but they both in creased after the treatnment (P<0.01 or 0.05) with more significance in experimental group (P<0.05).Conclusion Thyroid hormone could make an effect in the process of development of CHF and thyroid hormone,if given properly,could be helpful to CHF.

关 键 词：充血性心力衰竭 CHF 甲状腺激素水平 激素治疗 病情判断 

分 类 号：R541.61[医药卫生—心血管疾病]