[1]杜蔚蓓,张建伟.CHF患者血清甲状腺激素异常及小剂量左甲状腺素钠治疗的效果[J].医学信息,2020,33(15):73.[doi:10.3969/j.issn.1006-1959.2020.15.023]
 DU Wei-bei,ZHANG Jian-wei.Serum Thyroid Hormone Abnormalities in CHF Patients and the Effect of Low-dose Levothyroxine Sodium Therapy[J].Medical Information,2020,33(15):73.[doi:10.3969/j.issn.1006-1959.2020.15.023]
点击复制

CHF患者血清甲状腺激素异常及小剂量左甲状腺素钠治疗的效果()
分享到:

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
33卷
期数:
2020年15期
页码:
73
栏目:
论著
出版日期:
2020-08-01

文章信息/Info

Title:
Serum Thyroid Hormone Abnormalities in CHF Patients and the Effect of Low-dose Levothyroxine Sodium Therapy
文章编号:
1006-1959(2020)15-0073-04
作者:
杜蔚蓓张建伟
昆明市第一人民医院内分泌科,云南 昆明 650011
Author(s):
DU Wei-beiZHANG Jian-wei
Department of Endocrinology,Kunming First People’s Hospital,Kunming 650011,Yunnan,China
关键词:
慢性心力衰竭甲状腺激素左甲状腺素钠心功能炎症因子
Keywords:
Chronic heart failureThyroid hormoneLevothyroxine sodiumHeart function Inflammatory factor
分类号:
R541.6
DOI:
10.3969/j.issn.1006-1959.2020.15.023
文献标志码:
A
摘要:
目的 探讨慢性心力衰竭(CHF)患者血清甲状腺激素水平及小剂量左甲状腺素钠治疗的效果。方法 选取2016年4月~2018年4月在我院治疗的CHF患者110例作为CHF组,同时选取健康志愿者100例作为正常组;同时根据治疗方案将CHF组分为观察组(52例)和对照组(58例),对照组给予常规治疗,观察组在对照组的基础给予小剂量左甲状腺素钠治疗。比较各组血清甲状腺激素水平,比较观察组和对照组治疗前后甲状腺激素水平、心功能指标、hs-CRP和IL-6水平及不良反应等。结果CHF组T3和FT3水平低于正常组,差异有统计学意义(P<0.05);CHF组和正常组T4、FT4和FSH水平比较,差异无统计学意义(P>0.05)。治疗后,观察组和对照组T4、FT4和FSH水平比较,差异无统计学意义(P>0.05);观察组和对照组T3和FT3均较治疗前升高,且观察组高于对照组,差异有统计学意义(P<0.05);观察组和对照组LVEF、CI和SV均较治疗前改善,且观察组LVEF、CI和SV高于对照组,差异有统计学意义(P<0.05);观察组和对照组hs-CRP、IL-6均较治疗前改善,且观察组hs-CRP、IL-6低于对照组,差异有统计学意义(P<0.05)。观察组和对照组未发现有严重并发症发生。结论 CHF患者血清T3和FT3水平低于正常人群,给予小剂量左甲状腺素钠能改善患者甲状腺激素水平和心脏功能,抑制炎症反应,安全性良好,值得临床应用。
Abstract:
Objective To investigate the serum thyroid hormone level and the effect of low-dose levothyroxine sodium in patients with chronic heart failure (CHF). Methods 110 CHF patients treated in our hospital from April 2016 to April 2018 were selected as the CHF group, and 100 healthy volunteers were selected as the normal group; at the same time, the CHF group was divided into the observation group (52 cases) according to the treatment plan and the control group (58 cases), the control group was given conventional treatment, and the observation group was given low-dose levothyroxine sodium treatment on the basis of the control group. The serum thyroid hormone levels of each group were compared, and the thyroid hormone levels, heart function indexes, hs-CRP and IL-6 levels and adverse reactions were compared between the observation group and the control group before and after treatment. Results The levels of T3 and FT3 in the CHF group were lower than those in the normal group,the difference was statistically significant (P<0.05); there was no significant difference in the levels of T4, FT4, and FSH between the CHF group and the normal group (P>0.05). After treatment, there was no statistically significant difference in the levels of T4, FT4 and FSH between the observation group and the control group (P>0.05); T3 and FT3 in the observation group and the control group were higher than before treatment, and the observation group was higher than the control group,the difference was statistically significant (P<0.05); the LVEF, CI and SV of the observation group and the control group were improved compared with before treatment, and the LVEF, CI and SV of the observation group were higher than the control group, the difference was statistically significant (P<0.05) ; The hs-CRP and IL-6 of the observation group and the control group were improved compared with before treatment, and the hs-CRP and IL-6 of the observation group were lower than the control group, the difference was statistically significant (P<0.05). No serious complications were found in the observation group and the control group. Conclusion The serum T3 and FT3 levels of CHF patients are lower than those of the normal population. Low-dose levothyroxine sodium can improve patients’ thyroid hormone levels and cardiac function, inhibit inflammation, and has good safety. It is worthy of clinical application.

参考文献/References:

[1]Nakabayashi K,Nakazawa N,Suzuki T,et al.Thyroid Echography-induced Thyroid Storm and Exacerbation of Acute Heart Failure[J]. Internal Medicine,2016,55(16):2209-2212.[2]Lima LFD,Barbosa F,Simoes MV,et al.Heart failure, micronutrient profile, and its connection with thyroid dysfunction and nutritional status[J]. Clinical Nutrition,2018,35(06):103-106.[3]中华心血管病杂志编辑委员会中华医学会心血管病学分会.中国心力衰竭诊断和治疗指南2014[J].中华心血管病杂志,2014,22(2):98-122.[4]刘晨,袁晓晨,张振刚,等.探讨甲状腺激素与慢性心力衰竭患者心房颤动发生率的相关性[J].中国循环杂志,2015,30(8):749-752.[5]Godo S,Kawazoe Y,Ozaki H,et al.Switching Therapy from Intravenous Landiolol to Transdermal Bisoprolol in a Patient with Thyroid Storm Complicated by Decompensated Heart Failure and Gastrointestinal Dysfunction[J].Internal Medicine,2017,56(19):2603-2609.[6]Janssen R,Muller A,Simonides WS.Cardiac Thyroid Hormone Metabolism and Heart Failure[J].European Thyroid Journal,2017,6(3):130-137.[7]Vargas-Uricoechea H,Bonelo-Perdomo A.Thyroid Dysfunction and Heart Failure: Mechanisms and Associations[J]. Current Heart Failure Reports,2017,14(1):48-58.[8]颜素岚,郑昭芬,练宇,等.心力衰竭患者心功能分级、血清N末端脑钠肽前体与甲状腺激素水平的相关性研究[J].中华生物医学工程杂志,2017,23(1):19-23.[9]王婷婷,李辉,范建国,等.老年慢性心力衰竭患者甲状腺激素和同型半胱氨酸水平与心功能关系的研究[J].中国血液流变学杂志,2016,26(2):227-229.[10]牛伟华,李广平.慢性心力衰竭患者甲状腺激素水平与认知功能的相关性研究[J].天津医科大学学报,2016,22(1):21-23.[11]刘克琴,倪海滨,俞辰斌,等.急性心力衰竭患者甲状腺激素水平与全血脑利钠肽动态变化相关性研究[J].中国急救复苏与灾害医学杂志,2015,10(3):296-298.[12]钱荟,陈润唯,刘璟璐,等.慢性心力衰竭患者甲状腺激素和心功能变化[J].中国老年学杂志,2015,35(22):6380-6381.[13]王翠艳,王丽辉.老年慢性心力衰竭患者心功能与甲状腺激素、氨基末端脑钠肽前体的变化及对预后的影响[J].中国临床医生杂志,2016,44(1):32-35.[14]汪晓刚,刘加麟,李凯,等.老年心力衰竭患者血中甲状腺激素和N末端原脑钠肽的检测及临床意义[J].海南医学院学报,2015,21(3):323-325.[15]葛晓平,潘方瑛,金小璐.左甲状腺素钠治疗对慢性充血性心力衰竭患者甲状腺激素水平的影响研究[J].中国地方病防治杂志,2016,31(4):454-455.

相似文献/References:

[1]贺明清,刘孝娅.环磷腺苷葡胺治疗慢性心力衰竭临床疗效观察[J].医学信息,2018,31(10):135.[doi:10.3969/j.issn.1006-1959.2018.10.045]
 HE Ming-qing,LIU Xiao-ya.Clinical Efficacy of Cyclic Adenosine Glucosamine in the Treatment of Chronic Heart Failure[J].Medical Information,2018,31(15):135.[doi:10.3969/j.issn.1006-1959.2018.10.045]
[2]李鹏飞,何荣华,王琼涛,等.单胺氧化酶对老年心力衰竭患者临床应用价值[J].医学信息,2018,31(17):78.[doi:10.3969/j.issn.1006-1959.2018.17.023]
 LI Peng-fei,HE Rong-hua,WANG Qiong-tao,et al.Clinical Value of Monoamine Oxidase in Elderly Patients with Heart Failure[J].Medical Information,2018,31(15):78.[doi:10.3969/j.issn.1006-1959.2018.17.023]
[3]杨锦龙,刘 欢.甲状腺激素测定在高血压心力衰竭患者中的临床意义[J].医学信息,2018,31(22):96.[doi:10.3969/j.issn.1006-1959.2018.22.026]
 YANG Jin-long,LIU Huanc.Clinical Signifcance of Changes of Serum Thyroid Hormone Levels in Hypertensive Patients with Chronic Heart Failure[J].Medical Information,2018,31(15):96.[doi:10.3969/j.issn.1006-1959.2018.22.026]
[4]曹 云,李树茂,裘 冬,等.益气温阳中药治疗慢性舒张性心力衰竭的疗效观察[J].医学信息,2019,32(01):162.[doi:10.3969/j.issn.1006-1959.2019.01.051]
 CAO Yun,LI Shu-mao,QIU Dong,et al.Therapeutic Effect of Yiqiwenyang Chinese Medicine on Chronic Diastolic Heart Failure[J].Medical Information,2019,32(15):162.[doi:10.3969/j.issn.1006-1959.2019.01.051]
[5]韩婷婷,王 虹,吴美美,等.N-proBNP对慢性心衰患者发生肺动脉高压的预测价值[J].医学信息,2019,32(05):114.[doi:10.3969/j.issn.1006-1959.2019.05.035]
 HAN Ting-ting,WANG Hong,WU Mei-mei,et al.Predictive Value of N-proBNP for Pulmonary Hypertension in Patients with Chronic Heart Failure[J].Medical Information,2019,32(15):114.[doi:10.3969/j.issn.1006-1959.2019.05.035]
[6]李 月,胡 雅,曹春乐,等.慢性心力衰竭患者健康心理控制源与自我管理的相关性研究[J].医学信息,2019,32(05):133.[doi:10.3969/j.issn.1006-1959.2019.05.042]
 LI Yue,HU Ya,CAO Chun-le,et al.Correlation between Health Psychological Control Sources and Self-management in Patients with Chronic Heart Failure[J].Medical Information,2019,32(15):133.[doi:10.3969/j.issn.1006-1959.2019.05.042]
[7]张文波,杨玉雯.希氏束起搏在慢性心力衰竭患者中的应用[J].医学信息,2019,32(10):41.[doi:10.3969/j.issn.1006-1959.2019.10.015]
 ZHANG Wen-bo,YANG Yu-wen.Application of His Bundle Pacing in Patients with Chronic Heart Failure[J].Medical Information,2019,32(15):41.[doi:10.3969/j.issn.1006-1959.2019.10.015]
[8]张凤娜,高伟勤.6min步行试验训练对慢性心力衰竭患者心功能的影响[J].医学信息,2019,32(16):97.[doi:10.3969/j.issn.1006-1959.2019.16.030]
 ZHANG Feng-na,GAO Wei-qin.The Effect of 6min Walking Test Training on Cardiac Function in Patients with Chronic Heart Failure[J].Medical Information,2019,32(15):97.[doi:10.3969/j.issn.1006-1959.2019.16.030]
[9]蒲军亮,张 婷.沙库巴曲缬沙坦钠片联合琥珀酸美托洛尔缓释片治疗慢性心力衰竭的疗效观察[J].医学信息,2020,33(14):159.[doi:10.3969/j.issn.1006-1959.2020.14.051]
 PU Jun-liang,ZHANG Ting.Observation of Sacubitril Valsartan Sodium Tablets Combined with Metoprolol Succinate Sustained-release Tablets in the Treatment of Chronic Heart Failure[J].Medical Information,2020,33(15):159.[doi:10.3969/j.issn.1006-1959.2020.14.051]
[10]袁 超.沙库巴曲缬沙坦联合比索洛尔治疗慢性心力衰竭的效果[J].医学信息,2020,33(19):135.[doi:10.3969/j.issn.1006-1959.2020.19.041]
 YUAN Chao.Effect of Sacubitril Valsartan Combined with Bisoprolol in the Treatment of Chronic Heart Failure[J].Medical Information,2020,33(15):135.[doi:10.3969/j.issn.1006-1959.2020.19.041]

更新日期/Last Update: 1900-01-01