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目的:探讨甲状腺素对慢性心力衰竭(chronic heart failure,CHF)患者心功能及血管内皮功能的影响及安全性。方法:选择CHF心功能级患者134例,随机分为对照组68例和进行甲状腺素治疗的治疗组66例,比较两组治疗前后和两组治疗后甲状腺功能(主要评价指标:3,5,3,-triiodothyronine,T3;3,5,3,5,-tetraiodothyronine,T4;thyroid stimulating hormone,TSH)、心脏彩超(主要评价指标:left ventricular ejection fractions,LVEF;cardiac output,Co;left ventricular end-diameter systolic,LVDS;left ventricular end-diameter diastolic,LVDD)、明尼苏达心力衰竭生活质量评分(简称:生活质量评分)、6min步行距离以及评价血管内皮功能(主要评价指标:endothelin,ET;nitric oxide,NO)。结果:甲状腺功能指标:治疗组T3改善显著(P<0.05),和对照组比较亦改善显著(P<0.01),T4、TSH变化不显著;心脏泵血功能参数(LVEF、Co)和结构参数(LVDD,LVDS)显著改善(P<0.01),治疗组改善更显著(P<0.01);两组生活质量评分治疗前后均显著改善(P<0.05),治疗组改善更显著(P<0.05)。两组治疗前后6min步行距离均显著改善(P<0.01),治疗组改善更显著(P<0.01)。两组患者治疗前后ET、NO均显著改善(P<0.05),治疗组改善更显著(P<0.05)。治疗组未出现甲状腺素的明显副作用。结论:甲状腺素能改善CHF患者心功能及血管内皮功能且安全。
Objective: To investigate the effect and safety of thyroxine on cardiac function and endothelial function in patients with chronic heart failure (CHF). Methods: One hundred and sixty-four CHF patients with CHF were randomly divided into control group (n = 68) and thyroxine treatment group (n = 66). Thyroid function was compared between the two groups before and after treatment 3, 3, 3, 5, 5, -tetraiodothyronine, T4; thyroid stimulating hormone, TSH); left ventricular ejection fractions (LVEF; cardiac output, Co; left ventricular end- (left ventricular end-diastolic, left ventricular end-diastolic, LVDD), Minnesota heart failure quality of life score (referred to as quality of life score), walking distance 6min and evaluation of vascular endothelial function (main evaluation index: ). Results: Thyroid function index improved significantly (P <0.05) in the treatment group and significantly improved compared with the control group (P <0.01), T4 and TSH did not change significantly. The parameters of cardiac pump function (LVEF, Co) and structure parameters (P <0.01). The quality of life of the two groups improved significantly (P <0.05), the treatment group improved more significantly (P <0.05) . The distance between the two groups was significantly improved 6min before and after treatment (P <0.01), the treatment group improved more significantly (P <0.01). The ET and NO in both groups were significantly improved before and after treatment (P <0.05), and the treatment group improved more significantly (P <0.05). The treatment group did not appear obvious side effects of thyroxine. Conclusion: Thyroxine can improve cardiac function and vascular endothelial function in patients with CHF.