CHF患者血清甲状腺激素异常及小剂量左甲状腺素钠治疗的效果  

Serum Thyroid Hormone Abnormalities in CHF Patients and the Effect of Low-dose Levothyroxine Sodium Therapy

作　　者：杜蔚蓓[1] 张建伟[1] DU Wei-bei;ZHANG Jian-wei(Department of Endocrinology,Kunming First People's Hospital,Kunming 650011,Yunnan,China)

机构地区：[1]昆明市第一人民医院内分泌科,云南昆明650011

出　　处：《医学信息》2020年第15期73-75,84,共4页Journal of Medical Information

摘　　要：目的探讨慢性心力衰竭(CHF)患者血清甲状腺激素水平及小剂量左甲状腺素钠治疗的效果。方法选取2016年4月~2018年4月在我院治疗的CHF患者110例作为CHF组,同时选取健康志愿者100例作为正常组;同时根据治疗方案将CHF组分为观察组(52例)和对照组(58例),对照组给予常规治疗,观察组在对照组的基础给予小剂量左甲状腺素钠治疗。比较各组血清甲状腺激素水平,比较观察组和对照组治疗前后甲状腺激素水平、心功能指标、hs-CRP和IL-6水平及不良反应等。结果CHF组T3和FT3水平低于正常组,差异有统计学意义(P<0.05);CHF组和正常组T4、FT4和FSH水平比较,差异无统计学意义(P>0.05)。治疗后,观察组和对照组T4、FT4和FSH水平比较,差异无统计学意义(P>0.05);观察组和对照组T3和FT3均较治疗前升高,且观察组高于对照组,差异有统计学意义(P<0.05);观察组和对照组LVEF、CI和SV均较治疗前改善,且观察组LVEF、CI和SV高于对照组,差异有统计学意义(P<0.05);观察组和对照组hs-CRP、IL-6均较治疗前改善,且观察组hsCRP、IL-6低于对照组,差异有统计学意义(P<0.05)。观察组和对照组未发现有严重并发症发生。结论CHF患者血清T3和FT3水平低于正常人群,给予小剂量左甲状腺素钠能改善患者甲状腺激素水平和心脏功能,抑制炎症反应,安全性良好,值得临床应用。Objective To investigate the serum thyroid hormone level and the effect of low-dose levothyroxine sodium in patients with chronic heart failure(CHF).Methods 110 CHF patients treated in our hospital from April 2016 to April 2018 were selected as the CHF group,and 100 healthy volunteers were selected as the normal group;at the same time,the CHF group was divided into the observation group(52 cases)according to the treatment plan and the control group(58 cases),the control group was given conventional treatment,and the observation group was given low-dose levothyroxine sodium treatment on the basis of the control group.The serum thyroid hormone levels of each group were compared,and the thyroid hormone levels,heart function indexes,hs-CRP and IL-6 levels and adverse reactions were compared between the observation group and the control group before and after treatment.Results The levels of T3 and FT3 in the CHF group were lower than those in the normal group,the difference was statistically significant(P<0.05);there was no significant difference in the levels of T4,FT4,and FSH between the CHF group and the normal group(P>0.05).After treatment,there was no statistically significant difference in the levels of T4,FT4 and FSH between the observation group and the control group(P>0.05);T3 and FT3 in the observation group and the control group were higher than before treatment,and the observation group was higher than the control group,the difference was statistically significant(P<0.05);the LVEF,CI and SV of the observation group and the control group were improved compared with before treatment,and the LVEF,CI and SV of the observation group were higher than the control group,the difference was statistically significant(P<0.05);The hs-CRP and IL-6 of the observation group and the control group were improved compared with before treatment,and the hs-CRP and IL-6 of the observation group were lower than the control group,the difference was statistically significant(P<0.05).No serious complications were found in the observ

关 键 词：慢性心力衰竭 甲状腺激素 左甲状腺素钠 心功能 炎症因子 

分 类 号：R541.6[医药卫生—心血管疾病]