CAJ | 학술논문

目的：探讨复方丹参滴丸对初诊甲状腺功能减退症(甲减)患者颈动脉内膜中层厚度(CIMT)及心功能的影响。方法亚临床甲减(亚甲减)和临床甲减患者各40例。将临床甲减患者随机均分为左甲状腺素(L￣T4)常规治疗组(常规组)和复方丹参滴丸配伍 L￣T4治疗组(丹参组),均治疗6个月,结合甲状腺功能、血脂谱、超声评价疗效。设40例健康受试者为正常对照组。结果与正常对照组比较,亚甲减组总胆固醇(TC)、低密度脂蛋白胆固醇(LDL￣C)升高(P<0.05)；临床甲减组 TC、LDL￣C 升高更显著(P<0.01),且 CIMT 明显增加、左心室收缩功能(射血分数)与舒张功能(二尖瓣血流 E 峰/ A 峰)显著降低(P<0.05)。治疗后,随着甲状腺功能恢复,临床甲减组血脂谱均改善(P<0.05),CIMT 减少(P<0.05),左心室功能恢复至接近正常；丹参组 CIMT 减少幅度和心功能恢复程度均大于常规组(P<0.05)。结论甲减患者已有脂质紊乱,CIMT 增加和左心室功能受损提示客观存在心、脑血管危险。复方丹参滴丸有助于甲减患者改善脂质代谢,逆转 CIMT 和心功能,降低心血管风险,阻断或延缓心血管事件链。
목적：탐토복방단삼적환대초진갑상선공능감퇴증(갑감)환자경동맥내막중층후도(CIMT)급심공능적영향。방법아림상갑감(아갑감)화림상갑감환자각40례。장림상갑감환자수궤균분위좌갑상선소(L￣T4)상규치료조(상규조)화복방단삼적환배오 L￣T4치료조(단삼조),균치료6개월,결합갑상선공능、혈지보、초성평개료효。설40례건강수시자위정상대조조。결과여정상대조조비교,아갑감조총담고순(TC)、저밀도지단백담고순(LDL￣C)승고(P<0.05)；림상갑감조 TC、LDL￣C 승고경현저(P<0.01),차 CIMT 명현증가、좌심실수축공능(사혈분수)여서장공능(이첨판혈류 E 봉/ A 봉)현저강저(P<0.05)。치료후,수착갑상선공능회복,림상갑감조혈지보균개선(P<0.05),CIMT 감소(P<0.05),좌심실공능회복지접근정상；단삼조 CIMT 감소폭도화심공능회복정도균대우상규조(P<0.05)。결론갑감환자이유지질문란,CIMT 증가화좌심실공능수손제시객관존재심、뇌혈관위험。복방단삼적환유조우갑감환자개선지질대사,역전 CIMT 화심공능,강저심혈관풍험,조단혹연완심혈관사건련。
Objective To investigate the effects of compound danshen dripping pill (CDDP) on carotid intima￣media thickness (CIMT) and cardiac function in patients newly diagnosed as hypothyroidism. Methods The total of 40 subclinical hypothyroidism patients and 40 hypothyroidism cases was enrolled.The clinical hypothyroidism patients were treated with L￣T4 as the conventional treatment, and comprehensive CDDP plus levothyroxine (L￣T4 ) as treated groups (CDDP group) for 6 months. The therapeutic effect was evaluated by combining with data of thyroid function, blood lipid profile and ultrasound.The 40 healthy subjects were chosen as normal control group. Results Compared with normal control group, the levels of TC and LDL￣C were higher (P<0.05) in subclinical hypothyroidism group, which were more obvious in the clinical hypothyroidism group (P<0.01), CIMT increased markedly (P<0.05), the left ventricular systolic functions (ejection fraction) and diastolic functions (mitral flow velocity E and A wave ratio) were markedly decreased (P<0.05) in the clinical hypothyroidism group.Upon treatment, the blood￣lipids were improved (P<0.05), CIMT were reduced (P<0.05), the left ventricular functions were restored to near normal with the attainment of euthyroidism in both groups of clinical hypothyroidism;the reduction of CIMT and the improvement of the left ventricular functions were faster in CDDP group than that in the conventional treatment group (P<0.05). Conclusion Disturbance of blood lipid in hypothyroidism patients, CIMT growth and impaired left ventricular function objectively indicate the existence of cardiac and cerebral vascular risk, while CDDP helps improving lipid metabolism, reversing CIMT and cardiac function, reducing cardiovascular risk, blocking or delaying cardiovascular event chains.