左甲状腺素钠治疗慢性心功能不全并正常甲状腺病态综合征的临床研究

目的 探讨在常规抗心力衰竭治疗基础上加用小剂量左甲状腺素钠治疗慢性心力衰竭合并正常甲状腺病态综合征(ESS)的疗效.方法 将慢性心力衰竭合并ESS患者70例随机分为对照组及治疗组,对照组患者给予常规抗心衰治疗,治疗组在此基础上加服左甲状腺素钠片治疗1年,观察两组患者治疗前、后的相关检查和化验指标.结果 治疗组及对照组患者12个月后6min步行试验分别为(383.0±48.7)m,(339.3±37.8)m]、NYHA心功能分级(分别为(2.7±0.4)级,(3.2±0.5)级]、LVEF分别为(40.87±8.18)％,(35.38±7.35)％]、BNP分别为(197.74±20.58) ng/L,(302.01±10.15) ng/L]均较入组时分别为(317.0±36.6) m,(323.4±44.8)m;(3.5±0.5)级,(3.5±0.3)级；(33.18±7.29)％,(34.74±9.81)％;(369.75±21.15) ng/L,(345.56±18.65) ng/L]好转,治疗组较对照组表现更明显(t=2.974、3.698、9.136、7.476,均P＜0.05)；治疗组患者1年内总心血管事件显著少于对照组(分别为27、17例次)(x2=4.96,P＜0.05).结论 在慢性心功能不全患者常规抗心衰治疗基础上,加用小剂量左甲状腺素钠治疗能够改善患者生活质量,减少医疗费用.

Clinical study of levothyroxine sodium in the treatment of patients with heart failure and euthyroid sick syndrome

Objective To investigate effect on patients with chronic heart failure complicated with euthyroid sick syndrome（ESS） who had given small dose of levothyroxine sodium that based on the routine anti heart failure therapy.Methods 70 patients with chronic cardiac insufficiency and ESS were randomly divided into control group and treatment group,the control group patients were given routine anti heart failure treatment,while the treatment group plus levothyroxine sodium tablets for 1year.Observe and compare the relevant examination and laboratory indexes of 2 groups before and after treatment,follow up the number of vascular events about 2 groups within 1year.Results The 6 minutes walk testRespectively：（383.0±48.7）m,（339.3±37.8）m],NYHA heart function classificationRespectively：（2.7±0.4）grade,（3.2±0.5）grade],LVEFRespectively：（40.87±8.18）%,（35.38±7.35）%],BNPRespectively：（197.74±20.58）ng/L,（302.01±10.15）ng/L]water of the treatment groupRespectively：（317.0±36.6）m,（323.4±44.8）m,（3.5±0.5）grade,（3.5±0.3）grade,（33.18±7.29）%,（34.74±9.81）%,（369.75±21.15）ng/L,（345.56±18.65）ng/L] and the control group were better than before treatment.The treatment group was more significant,the two groups after treatment had a significant difference（t=2.974,3.698,9.136,7.476,all P〈0.05）,the number of cardiovascular events of the treatment group was decreased within 1 year,compared with the control group the difference was statistically significant（χ2=4.96,P〈0.05）.Conclusion In the treatment of conventional heart failure therapy combined with a small dose of levothyroxine sodium therapy on chronic heart failure patients can improve the patients′ quality of life,reduce medical costs.