甲状腺激素水平与充血性心力衰竭的相关性以及小剂量甲状腺素的干预作用

目的:探讨甲状腺激素水平与充血性心力衰竭(CHF)的相关性,观察小剂量甲状腺素治疗CHF的效果。方法:采用放射免疫法测定68例充血性心力衰竭患者(CHF组)及50例健康对照者(对照组)的血清三碘甲腺原氨酸(T3)、游离三碘甲腺原氨酸(FT3)、甲状腺素(T4)、游离甲状腺素(FT4)和促甲状腺激素(TSH)水平,并进行比较。然后将甲状腺素水平降低的52例CHF患者分为观察组和治疗组,分别给予常规抗心衰治疗和常规抗心衰治疗+小剂量甲状腺素治疗,比较两组患者治疗前后心功能变化情况。结果:CHF组与对照组相比,T3、FT3水平明显降低(P0.05),且心力衰竭程度越重,T3、FT3水平降低越明显(P0.05),T4、FT4、TSH水平无显著性差异(P0.05)。CHF治疗组心功能改善明显优于CHF观察组(P0.05)。结论:CHF患者常伴有血清甲状腺素水平下降,且甲状腺素水平降低与心衰程度密切相关。短程小剂量甲状腺素治疗CHF安全、有效。

The Relationship between the Level of Thyroid Hormone and Cardiac Function and the Response to Low-dose of Thyroxine in Patients with Congestive Heart Failure

Objective To explore the relationship between thyroid hormone and cardiac function in congestive heart failure（CHF） and the effect of low-dose thyroxine on patients with CHF.Methods The triiodothyronine（T3）,free-triiodothyronine（FT3）,thyroxine （T4）,free-thyroxine （FT4） and thyroxinethyroid stimulating hormone（TSH） were measured in 68 patients with CHF（CHF group） and 50 healthy people （control group） by radioimmunoassay.Then the 52 CHF cases with decreased thyroid hormone were divided into thyroxine group and observe group.The patients in thyroxine group received conventional anti-heart failure therapy and low-dose thyroid hormone while the patients in observe group received conventional anti-heart failure therapy only.The heart function before and after the therapy was compared between two groups.Results The level of T3 and FT3 in CHF group was markedly 1ower than that in control group （P0.05）.The level of T3 and FT3 decreased more with the heart failure exacerbating （P0.05）.The improvement of cardiac function in thyroxine group was superior than that in observe group （P0.05）.Conclusions The level of T3 and FT3 in patients with CHF was decreased and it was correlated with the severity of heart failure.The low-dose thyroxine was safe and effective in patients with congestive heart failure.