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目的探讨小剂量左旋甲状腺素对老年慢性心力衰竭并亚临床甲减心功能的影响。方法18例老年慢性心力衰竭并亚临床甲减患者,从12.5μg/d开始予口服左旋甲状腺素,缓慢增加剂量,使血清促甲状腺素介于4～6mIU/L,观察1年。结果服药12月时与服药前比较,超声心动图检查左室舒张末内径、左室收缩末内径明显缩小,射血分数明显增加,差异有显著性;服药6、12月与治疗前比较,室速、室性早搏均明显减少,差异有统计学意义;血压、心率无明显变化。结论小剂量左旋甲状腺素能明显改善老年心衰并亚临床甲减患者的心功能,增加射血分数,减少室速、室性早搏的发生。
Objective To investigate the effect of low dose of L-thyroxine on the elderly patients with chronic heart failure and subclinical hypothyroidism. Methods Eighteen elderly patients with chronic heart failure and subclinical hypothyroidism were given oral levothyroxine starting from 12.5 μg / day and the dosage of thyroxine was slowly increased to 4 ~ 6 mIU / L for 1 year. Results Compared with before treatment, the left ventricular end-diastolic diameter and left ventricular end-systolic diameter were significantly reduced by echocardiography and the ejection fraction was significantly increased at 12 months after taking the drug. The difference was significant at 6 and 12 months Speed, premature ventricular contraction were significantly reduced, the difference was statistically significant; blood pressure, heart rate no significant change. Conclusion Low-dose L-thyroxine can significantly improve heart function in elderly patients with heart failure and subclinical hypothyroidism, increase ejection fraction, and decrease the incidence of ventricular tachycardia and ventricular premature beats.