不同剂量甲状腺激素治疗扩张型心肌病心力衰竭临床疗效观察

目的：观察不同剂量甲状腺激素对扩张型心肌病（DCM）心力衰竭的疗效，探索其安全有效剂量。方法：123例DCM心力衰竭患随机分为A，B，C三组，在常规抗心力衰竭治疗组上分别加服甲状腺激素20gm/d,40mg/d,60mg/d，疗程4周，治疗前后测血清T3，T4水平，观察心功能改善情况，以超声心动图，X线胸片观察心脏各参数变化。结果：经甲状腺激素治疗后三组血清T3，T4明显升高，C组高于正常值；A，B两组心功能改善优于C组，A，B两组心脏各参数较治疗前改善明显，而C组明显不明显。结论：甲状腺激素治疗DCM心力衰竭安全有效剂量为20－40mg/d。

Clinical study on effects of different dosages of thyroxine in the treatment of patients of dilated cardiomyopathy with congestive heart failure

Objective:To observe the therappeuticd effect of different dosages of thyroid hormone in the treatemnt of the patients of dilated cardiomyopathy (DCM)with congestive heart failure and trace the safe,effective dosage of it.Methods:123 patients of DCM with heart failure were randomly divided into 3 groups (goup A,B,C).On the basis of regular anti-heart failure therapy,each group them was treated with thyroxine 20mg/d(group A),40mg/d(group B),or 60mg/d(group C) respectively for 4 week.The level of serum T 3 T 4,the function of heart,the heart-thorax ratios,the cardio-morphologic and paramenters were observed before and after treatment.Results:the level of serum T 3,T 4 of three greoups increased significantly,serum T 3,T 4 in group C was higher than normal level;the improvement of function of heart of group A?B were significantly better than group C;the cardio-morphologic and function parameters of group A?B were significantly improved after treatment,but group C wasn't significant.Conclusion:the safe?effective dosage of thyroxine for the treatment of DCM with heart failure is 20~40mg/d.