慢性心力衰竭与正常甲状腺功能病态综合征的相关性研究进展

随着心力衰竭患者的住院率及死亡率逐年增长,国内外学者越来越关注甲状腺激素在心力衰竭的发生发展中的作用.正常的甲状腺激素水平对于维持心脏正常收缩和舒张功能至关重要.近年来研究发现,慢性心力衰竭患者普遍存在正常甲状腺功能病态综合征,即游离三碘甲状腺原氨酸(FT3)、三碘甲状腺原氨酸(T3)降低,或者FT3、T3及游离甲状腺素(FT4)、四碘甲状腺原氨酸(T4)均降低,反三碘甲状腺原氨酸(rT3)升高,而血清促甲状腺激素(TSH)正常,在这种病理状态下,心力衰竭进一步恶化,进入恶性循环.故监测血清甲状腺激素水平,有益于评估心力衰竭患者病情严重程度及预后,对于伴有正常甲状腺功能病态综合征的心力衰竭患者可在常规治疗心力衰竭的基础上加用小剂量短疗程的甲状腺激素治疗,这有利于患者心功能的恢复.

Study on the correlation between chronic heart failure and euthyroid sick syndrome

As hospitalization and mortality rate of chronic heart failure increased, scholars are paying more and more attention to the role of thyroid hormone in the development of heart failure. Normal level of thyroid hormone is very important to maintain normal cardiac systolic and diastolic function. In recent years, some studies suggest that pa-tients with chronic heart failure commonly have euthyroid sick syndrome, with reduced level of FT3, T3 or reduced level of FT3, T3 and FT4, T4, increased level of rT3, and normal TSH level. In this state of pathology, heart failure have be-came worsening into the vicious circle. So the monitoring of serum thyroid hormone levels are beneficial to the assess-ment of disease severity and prognosis of heart failure patients. For patients of heart failure with euthyroidsick syn-drome, it is recommended to apply a small dose of thyroid hormone therapy for a short course on the basis of convention-al treatment, which is helpful to the recovery of the patients' cardiac function.