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目的探讨小剂量甲状腺素(优甲乐)对慢性心衰治疗的效果。方法将60例慢性难治性心衰合并低T3综合征患者随机分成常规组与对照组各30例,两组均给予抗心衰常规治疗,对照组加用小剂量甲状腺素(优甲乐)。治疗后观察患者甲状腺素水平、心脏超声心动图指标、6min步行实验及心功能分级。结果对照组经治疗后血清总三碘甲状腺原氨酸(T3)、游离三碘甲状腺原氨酸(FT3),总甲状腺素(T4)、游离甲状腺素(FT4)均较治疗前明显升高(P<0.05),而促甲状腺素(TSH)治疗前后差异无显著性(P>0.05),两组均未见甲状腺中毒表现。治疗组治疗后的LVDd,E/A,LVEF,心功能分级及6min步行实验与治疗前及对照组治疗后比较均有明显改善,差异均有显著性(P<0.05)。结论慢性心衰伴低T3综合征患者经小剂量甲状腺素治疗,对心功能具有明显改善作用,未发现明显不良反应。
Objective To investigate the effect of low-dose thyroxine (Euthyrox) on the treatment of chronic heart failure. Methods Sixty patients with chronic refractory heart failure complicated with low T3 syndrome were randomly divided into the control group and the control group, 30 cases in each group. Both groups were given routine anti-heart failure treatment. The control group was given low dose of thyroxine (Euthyrox) . Thyroxine levels, echocardiographic parameters, 6-minute walking test and cardiac function were observed after treatment. Results The serum total triiodothyronine (T3), free triiodothyronine (FT3), total thyroxine (T4) and free thyroxine (FT4) in the control group were significantly higher than those before treatment P <0.05). There was no significant difference between before and after thyrotropin (TSH) treatment (P> 0.05). No thyroid poisoning was observed in both groups. After treatment, LVDd, E / A, LVEF, heart function grading and 6-minute walk test in treatment group were significantly improved compared with before treatment and control group after treatment, the difference was significant (P <0.05). Conclusion Chronic heart failure with low T3 syndrome patients treated with low dose of thyroxine has a significant improvement on cardiac function, no significant adverse reactions were found.