左卡尼汀对糖尿病合并心力衰竭患者甲状腺功能的影响  

Effect of L-carnitine on diabetic patients with thyroid function in patients with chronic heart fail-lure

作　　者：胡军[1] 杨少娟[1] 朱琳[1] 江燕丽 廖丹[1] 张瑶[1] 陈敏[2] 

机构地区：[1]华中科技大学同济医学院附属梨园医院内分泌科,武汉430077 [2]华中科技大学同济医学院附属梨园医院急诊内科,武汉430077

出　　处：《临床内科杂志》2015年第9期539-541,共3页Journal of Clinical Internal Medicine

摘　　要：目的：观察左卡尼汀治疗2型糖尿病合并慢性心力衰竭（CHF）患者甲状腺功能的变化。方法选择64例糖尿病合并慢性心力衰竭患者，随机分为左卡尼汀组及对照组各32例。两组均行常规抗心力衰竭治疗，左卡尼汀组在常规治疗基础上加用左卡尼汀2 g 静脉泵入，每天2次，共14天，检测用药14天后左心室射血分数（LVEF）、左心室短径缩短率（LVFS）、心排出量（CO）、氨基末端脑钠素前体（NT-pro-BNP）、三碘甲状腺原氨酸（T3）、游离三碘甲状腺原氨酸（FT3）、血清游离甲状腺素（FT4）、促甲状腺激素（TSH）等指标水平，并分别与治疗前及对照组各项指标进行比较。结果与治疗前及对照组比较，左卡尼汀组在改善心力衰竭患者心功能的同时，T3和 FT3水平上升（P ＜0．05），未见明显不良反应，且葡萄糖（GLU）、三酰甘油（TG）、胆固醇（CHO）较治疗前明显下降（P ＜0．05）。结论左卡尼汀治疗2型糖尿病合并慢性心力衰竭疗效较好，能改善患者甲状腺功能，且无明显不良反应。Objective To observe the changes of thyroid function in L-carnitine treatment of type 2 diabetes mellitus（DM）with chronic heart failure（CHF）patients.Methods 64 cases DMpatients with CHF were randomly divided into L-carnitine group（32 cases）and control group（32 cases）.Both groups underwent conventional anti-heart failure treatments.Besides,the L-carnitine group were treated with 2 g of L-carnitine in intravenous pump twice a day in a total amount of 14 d.Indicators such as left ventricular ejection fraction（LVEF）,left ventricular fractional shortening（LVFS）,cardiac output（CO）,N-terminal pro-brain natriuretic peptide（NT-pro-BNP）,triiod-thyronine（T3 ）,free triiodthyronine（FT3 ）,free thyrox-ine（FT4 ）and thyroid stimulating hormone（TSH）were detected 14 days after medical treatments,and each indicator was compared with the one before the treatments and the corresponding control group data re-spectively.Results L-carnitine improved heart function in patients with heart failure,T3 ,FT3 level com-pared with before treatment and the control group had significant increased difference（P 〈0.05）,showing no obvious adverse reactions,and glucose（GLU）,triglyceride（TG）,cholesterol（CHO）had sharp tenden-cies of declining compared to those before treatments.Conclusion L-carnitine have a significant effect on the treatments of type 2 diabetes mellitus with chronic heart failure.It can improve thyroid function and have no significant adverse reactions.

关 键 词：左卡尼汀 糖尿病 慢性心力衰竭 甲状腺激素 

分 类 号：R541.61[医药卫生—心血管疾病]