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目的观察小剂量甲状腺素长期治疗充血性心力衰竭 (CHF)的安全性及临床疗效。方法选择 2 0 3例扩张型心肌病或缺血性心肌病CHF患者 ,随机分为观察组和对照组。两组抗心衰基础治疗类同。观察组加服甲状腺片 ,2 0mg/d ,每 2个月复查血清甲状腺激素及心脏超声 ,最后入选病例观察 4个月。对比治疗前后心功能改善情况、血清甲状腺激素水平、左室舒张末期内径 (LVEDD)、左室射血分数 (LVEF)及两组再入院人次和病死率。结果两组心功能均有改善 ,观察组优于对照组 (P <0 .0 1 ) ,血清甲状腺激素T3、T4 均恢复至正常范围 ,观察组升高更明显 (P <0 .0 1 ) ;LVEDD、LVEF均改善 ,观察组优于对照组 (P <0 .0 1 ) ,再入院人次观察组较对照组减少 57.1 3 % ;观察组死亡 1 8例 (1 7.48% ) ,对照组死亡 1 7例 (1 7% ) ,两组无明显差异 (P >0 .0 5)。结论小剂量甲状腺素长期治疗CHF ,能显著改善心功能 ,减少再住院人次 ,无甲亢表现 ,不增加病死率。
Objective To observe the long-term efficacy and safety of low-dose thyroxine in the treatment of congestive heart failure (CHF). Methods Totally 203 CHF patients with dilated cardiomyopathy or ischemic cardiomyopathy were randomly divided into observation group and control group. Two groups of basic treatment of heart failure similar. The observation group plus thyroid tablets, 20mg / d, every 2 months review of serum thyroid hormone and cardiac ultrasound, the last selected cases observed for 4 months. The improvement of cardiac function, serum thyroid hormone level, left ventricular end-diastolic diameter (LVEDD), left ventricular ejection fraction (LVEF), and readmission rates and mortality were compared between before and after treatment. Results The heart function of both groups was improved, and the observation group was better than the control group (P <0.01). Serum thyroid hormone T3 and T4 returned to the normal range, the observation group increased more obviously (P <0.01) ; LVEDD and LVEF were improved in the observation group than in the control group (P <0.01); the readmission rate was 57.1% in the observation group and 18 (17.48%) in the observation group, while the death rate in the control group 1 7 cases (17%), no significant difference between the two groups (P> 0.05). Conclusions Long-term treatment of low-dose thyroxine CHF can significantly improve cardiac function, reduce re-admission times, no hyperthyroidism performance, do not increase mortality.