慢性心力衰竭患者血浆甲状腺激素测定的临床意义  

The Clinical Significance of Determination of Plasma Thyroid Hormone in patients with chronic 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：《心脑血管病防治》2003年第3期4-6,共3页CARDIO-CEREBROVASCULAR DISEASE PREVENTION AND TREATMENT

摘　　要：目的　探讨慢性心力衰竭 (CHF)患者甲状腺激素水平的变化与CHF的严重程度及应用甲状腺素治疗的临床意义。方法　对属于NYHA心功能分级为 2～ 4级的住院CHF患者 63例随机分为治疗组和治疗对照组 ,其中治疗组加用甲状腺素 40mg每日一次 ,疗程为 2周。两组治疗前后分别测定甲状腺激素水平 ,及彩色多普勒超声心动图检查 ,测定左室射血分数、左室短轴缩短率、每搏出量、心输出量及心脏指数。正常对照组 3 0例也测定甲状腺激素水平。结果　治疗组治疗 2周后的显效率为 61.2 9% ,优于治疗对照组 ,经统计学处理显效率有显著性差异 (P <0 .0 5 )。两组治疗后超声心动图上述指标均较治疗前有明显改善 (P <0 .0 5或 0 .0 1) ,但治疗组较治疗对照组改善更显著 (P <0 .0 5 )。治疗组和治疗对照组患者的T3水平较正常对照组降低 (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的发生发展过程中参与了一定的作用。Objective To investigate the alteration of thyroid hormone in the patients with chronic heart failure(CHF)and the clinical significance of treatment of thyroid hormone in patients with CHF.Methods 63 in-patients with CHF whose cardiac function of NYHA was between level 2 to level 4 were randomly divided into treatment group(n=31)and treatment control group (n=32).Patients in both groups were given routine treatment for CHF.In addition to CHF routine treatment,thyroid hormone 40 mg/d was given to the patients in treatment group for 2 weeks.Plasma thyroid hormone was determined before and after treatment in both groups toghther with 30 healthy people (normal group).At the same time,ejection fraction of left ventricle(LVEF),fractional shortening of left ventricle(FS),stroke volume(SV),cardiac output(CO),and cardiac index(CI)were determined by color doppler ultrasonic cardiaography in both treatment group and treatment control group before and after treatment.Results After 2 weeks' thyroid hormone treatment significant efficacy for treatment group was 61.29%,which were significantly higher than those in treatment control group ( P <0.05).Compared with before treatment,LVEF,FS,SV,CO and CI of patients in both two groups improved significanly after treatment( P <0.05 or P <0.01),but they improved more significantly in treatment group than in treatment control group( P <0.05).Plasma triiodothyronine(T 3)in both treatment group and treatment control group with CHF was lower than that in normal group( P <0.05).T 3 level in two groups increased( P <0.01 or 0.05)after treatment.But it increased more significantly in treatment group than in treatment control group( P <0.05).Conclusions Throid hormone takes a role in the process of development of CHF.It is useful to administer thyroid hormone to improve CHF.

关 键 词：慢性心力衰竭 血浆 甲状腺激素 测定 临床意义 治疗 超声心动图 

分 类 号：R541.6[医药卫生—心血管疾病]