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目的 :观察甲亢性心脏病人伴不同程度的心力衰竭时 β -受体阻滞剂的使用剂量及治疗作用。方法 :回顾性分析 30例甲亢性心脏病 (甲心病 )患者治疗中所用心得安的剂量和心脏功能改变情况。结果 :心功能属Ⅰ～Ⅳ级者分别为 1,2 ,14和 13例 ;射血分数依次为 80± 0 % ,6 6± 8.5 % ,6 6 .3± 8.8%和 5 8.8± 12 .8%。心得安剂量分别为 30mg/d ,35± 7.1mg/d ,5 5± 2 8.1mg/d和 5 7.7± 17.7mg/d。甲状腺功能亢进 (甲亢 )程度轻型为 5例 ,中型 13例 ,重型 12例 ,所用心得安剂量分别为 37.5± 15 .4mg/d ,4 2 .5± 15 .6mg/d和 78.8±2 0 .7mg/d。心衰纠正时间平均为 15 .8d(1～ 6 0d) ,无心衰加重者。结论 :甲心病伴心衰时 β-受体阻滞剂对心衰的纠正及甲亢症状的控制是有利的 ,剂量大小与甲亢程度有关 ;心功能Ⅲ～Ⅳ级患者、射血分数 >5 0 %时较大剂量使用无不良反应。
Objective: To observe the dosage and therapeutic effect of β - blockers in patients with hyperthyroid heart disease with different degrees of heart failure. Methods: A retrospective analysis of 30 cases of hyperthyroid heart disease (heart disease) in the treatment of patients with propranolol dose and cardiac function changes. Results: The heart function of Ⅰ ~ Ⅳ were 1, 2, 14 and 13 cases respectively. The ejection fraction was 80 ± 0%, 66 ± 8.5%, 66.3 ± 8.8% and 58.8 ± 12, respectively. 8%. Propranolol doses were 30 mg / d, 35 ± 7.1 mg / d, 55 ± 2 8.1 mg / d and 5 7.7 ± 17.7 mg / d, respectively. Hyperthyroidism (Hyperthyroidism) in 5 cases of light, 13 cases of medium, heavy in 12 cases, the use of propranolol doses were 37.5 ± 15 .4mg / d, 42.5 ± 15.6mg / d and 78.8 ± 20. 7mg / d. Heart failure correction time averaged 15.8 days (1 ~ 60d), no increase in heart failure. CONCLUSION: β-blockers in heart disease with heart failure are beneficial to the correction of heart failure and the control of hyperthyroidism. The dose size is related to the degree of hyperthyroidism. In patients with heart function Ⅲ ~ Ⅳ, the ejection fraction is> 50 No adverse reactions when using larger dose.