心力衰竭与甲状腺激素水平的关系及小剂量甲状腺素治疗心力衰竭疗效观察

目的：探讨甲状腺激素水平与充血性心力衰竭心衰程度的关系，观察小剂量甲状腺素治疗心力衰竭的效果。方法：对50例充血性心力衰竭患者（心力衰竭组）及30例健康对照者（对照组）的血清三碘甲状腺原氨酸（T3）、四碘甲状腺原氨酸（T4）、促甲状腺素（TSH）水平进行检测。同时检测30例低T3充血性心力衰竭患者和20例非低T3心力衰竭患者的左室射血分数（LVEF）。观察低T3充血性心力衰竭患者常规治疗组和加用小剂量甲状腺素治疗组治疗前后心功能变化情况。结果：充血性心力衰竭患者T3水平明显低于对照组（P〈0．001）。低T3心力衰竭患者的心衰程度严重。甲状腺素治疗组心功能改善优于常规治疗组。结论：充血性心力衰竭患者T3水平降低与心衰严重程度相关。小剂量甲状腺素治疗心力衰竭是安全、有效的。

The relationship between the level of thyroid hormone and cardiac function in congestive heart failure and the response to small dose of thyroxine in patients with congestive heart failure

Objective: To study the relationship between thyroid hormone and cardiac function in congestive heart failure and the response to small dose of thyroxine in patients with congestive heart failure. Methods: The thriiodothyronine (T-3), thyroxine (T-4), thyroid stimulating hormone (TSH) in 50 patients with chronic heart failure and 30 normal people were determined. The left ventricular ejection fraction (LVEF) was observed by echocardiography among the 30 low thiiodothyronine state cases with chronic heart failure and the 20 normal level thiiodothyronine state cases with chronic heart failure. The classes of heart function were assessed and the left ventricular ejection fraction was observed by echocardiography among the thyroxine group and the common group. Results: The level of T-3 in patients with chronic heart failure were remarkly lower than those in normal controls (P<0.001). The heart failure in low thiiodothyronine state cases was more severe (P<0.05). The improvement of LVEF in thyroxine group was superior than it in common group (P<0.01). Conclusion: The level of T-3 in patients with chronic heart failure was decreased, and it was correlated with the severity of heart failure. The small dose of thyroxine was safe and effective in patients with chronic heart failure of low thiiodothyronine state.