中国急救医学
中國急救醫學
중국급구의학
CHINESE JOURNAL OF CRITICAL CARE MEDICINE
2001年
1期
17-19
,共3页
季汉华%那开宪%张玉春%马莉%张慧敏%杨洪莹%王欣平%蔡起蔷%康苏平%张薇%侯新燕
季漢華%那開憲%張玉春%馬莉%張慧敏%楊洪瑩%王訢平%蔡起薔%康囌平%張薇%侯新燕
계한화%나개헌%장옥춘%마리%장혜민%양홍형%왕흔평%채기장%강소평%장미%후신연
左旋甲状腺素%充血 性心力衰竭%治疗
左鏇甲狀腺素%充血 性心力衰竭%治療
좌선갑상선소%충혈 성심력쇠갈%치료
目的 探讨左旋甲状腺素对充血性心力衰竭(CHF)的心功能及β受体反应性的影响。方法 23例CHF患者，男13例，女10例，平均年龄63岁，随机分为对照组：进行心力衰竭的一般治疗；治疗组：另外加用左旋甲状腺素(L-T 4)100μg,Qd，疗程2周。治疗期间记录体温、食欲、出汗等甲亢症状，治疗前后进行ECG 检查、血甲状腺激素水平的测定、超声心动图检查及进行多巴酚丁胺实验。结果 所有病例治疗期间无甲亢的症状，心功能明显好转；L-T4治疗组心功能改善程度优于对照组，血清T4比对照组明显升高(P＜0.001)，TSH略有下降(P＜0.05)。超声心动图显示两组心功能均好转，治疗组左心室舒张末期内径缩短更为明显。多巴酚丁胺实验显示治疗后两组平均动脉压及心率与治疗前相比均有显著性差异。结论 L-T4短期应用无明显副作用，可使CHF患者的心功能及左心室舒张末期内径改善。
目的 探討左鏇甲狀腺素對充血性心力衰竭(CHF)的心功能及β受體反應性的影響。方法 23例CHF患者，男13例，女10例，平均年齡63歲，隨機分為對照組：進行心力衰竭的一般治療；治療組：另外加用左鏇甲狀腺素(L-T 4)100μg,Qd，療程2週。治療期間記錄體溫、食欲、齣汗等甲亢癥狀，治療前後進行ECG 檢查、血甲狀腺激素水平的測定、超聲心動圖檢查及進行多巴酚丁胺實驗。結果 所有病例治療期間無甲亢的癥狀，心功能明顯好轉；L-T4治療組心功能改善程度優于對照組，血清T4比對照組明顯升高(P＜0.001)，TSH略有下降(P＜0.05)。超聲心動圖顯示兩組心功能均好轉，治療組左心室舒張末期內徑縮短更為明顯。多巴酚丁胺實驗顯示治療後兩組平均動脈壓及心率與治療前相比均有顯著性差異。結論 L-T4短期應用無明顯副作用，可使CHF患者的心功能及左心室舒張末期內徑改善。
목적 탐토좌선갑상선소대충혈성심력쇠갈(CHF)적심공능급β수체반응성적영향。방법 23례CHF환자，남13례，녀10례，평균년령63세，수궤분위대조조：진행심력쇠갈적일반치료；치료조：령외가용좌선갑상선소(L-T 4)100μg,Qd，료정2주。치료기간기록체온、식욕、출한등갑항증상，치료전후진행ECG 검사、혈갑상선격소수평적측정、초성심동도검사급진행다파분정알실험。결과 소유병례치료기간무갑항적증상，심공능명현호전；L-T4치료조심공능개선정도우우대조조，혈청T4비대조조명현승고(P＜0.001)，TSH략유하강(P＜0.05)。초성심동도현시량조심공능균호전，치료조좌심실서장말기내경축단경위명현。다파분정알실험현시치료후량조평균동맥압급심솔여치료전상비균유현저성차이。결론 L-T4단기응용무명현부작용，가사CHF환자적심공능급좌심실서장말기내경개선。
Objective To observe the effects of L-thyr oxine on cardiac function and β response to dobutamine of congestive heart fail ure(CHF).Methods A total of 23 patients with CHF were enr olled in the study.10 patients were randomizely assigned to control group with general treatment,13 pat ients assigned as treatment group were administered L-thyroxine (100 μg/day,orally)for two weeks.Clinical signs and symptoms of hyperthyroidism were recorded at all study period,before and at the end of study period of treatment,every patie nt was measured plasma levels of T3、T4、TSH and free T3、free T4、rT3 .A 12-lead electrocardiogram were recorded,echocardiogram was examined to evaluate index of cardiac function,dobutamine was infused intraveneously to evaluate cardiac response to the adrenergic stimulation.Results All patients had no clinical signs and symptoms of hyperthyroidism,cardiac function class were improved in two groups,but treatment group had better improved than c ontrol group.Plasma T4 level was obviously increased but TSH level has reduced after L-thyroxine treatment (P＜0.01 and P＜0.05).Echocardiogram was found cardiac function of two groups had improved,but left ventricular end-diastolic diameter of treatment group had markedly changed compared with control group .Dobutamine infusion was showed heart rate after treatment had significant differences in two groups compared with befo re treatment(P＜0.05).Conclusions L-thyroxine was well tolerated,and no adverse effects.Cardiac function and left ventricular end-diasto lic diameter had improved in CHF patients. Therefore, administration of L-thyro xine might be helped in a short term.
