CAJ | 학술논문

目的：观察左卡尼汀治疗2型糖尿病合并慢性心力衰竭（CHF）患者甲状腺功能的变化。方法选择64例糖尿病合并慢性心力衰竭患者，随机分为左卡尼汀组及对照组各32例。两组均行常规抗心力衰竭治疗，左卡尼汀组在常规治疗基础上加用左卡尼汀2 g 静脉泵入，每天2次，共14天，检测用药14天后左心室射血分数（LVEF）、左心室短径缩短率（LVFS）、心排出量（CO）、氨基末端脑钠素前体（NT-pro-BNP）、三碘甲状腺原氨酸（T3）、游离三碘甲状腺原氨酸（FT3）、血清游离甲状腺素（FT4）、促甲状腺激素（TSH）等指标水平，并分别与治疗前及对照组各项指标进行比较。结果与治疗前及对照组比较，左卡尼汀组在改善心力衰竭患者心功能的同时，T3和 FT3水平上升（P ＜0．05），未见明显不良反应，且葡萄糖（GLU）、三酰甘油（TG）、胆固醇（CHO）较治疗前明显下降（P ＜0．05）。结论左卡尼汀治疗2型糖尿病合并慢性心力衰竭疗效较好，能改善患者甲状腺功能，且无明显不良反应。
목적：관찰좌잡니정치료2형당뇨병합병만성심력쇠갈（CHF）환자갑상선공능적변화。방법선택64례당뇨병합병만성심력쇠갈환자，수궤분위좌잡니정조급대조조각32례。량조균행상규항심력쇠갈치료，좌잡니정조재상규치료기출상가용좌잡니정2 g 정맥빙입，매천2차，공14천，검측용약14천후좌심실사혈분수（LVEF）、좌심실단경축단솔（LVFS）、심배출량（CO）、안기말단뇌납소전체（NT-pro-BNP）、삼전갑상선원안산（T3）、유리삼전갑상선원안산（FT3）、혈청유리갑상선소（FT4）、촉갑상선격소（TSH）등지표수평，병분별여치료전급대조조각항지표진행비교。결과여치료전급대조조비교，좌잡니정조재개선심력쇠갈환자심공능적동시，T3화 FT3수평상승（P ＜0．05），미견명현불량반응，차포도당（GLU）、삼선감유（TG）、담고순（CHO）교치료전명현하강（P ＜0．05）。결론좌잡니정치료2형당뇨병합병만성심력쇠갈료효교호，능개선환자갑상선공능，차무명현불량반응。
Objective To observe the changes of thyroid function in L-carnitine treatment of type 2 diabetes mellitus(DM)with chronic heart failure(CHF)patients.Methods 64 cases DMpatients with CHF were randomly divided into L-carnitine group(32 cases)and control group(32 cases).Both groups underwent conventional anti-heart failure treatments.Besides,the L-carnitine group were treated with 2 g of L-carnitine in intravenous pump twice a day in a total amount of 14 d.Indicators such as left ventricular ejection fraction(LVEF),left ventricular fractional shortening(LVFS),cardiac output(CO),N-terminal pro-brain natriuretic peptide(NT-pro-BNP),triiod-thyronine(T3 ),free triiodthyronine(FT3 ),free thyrox-ine(FT4 )and thyroid stimulating hormone(TSH)were detected 14 days after medical treatments,and each indicator was compared with the one before the treatments and the corresponding control group data re-spectively.Results L-carnitine improved heart function in patients with heart failure,T3 ,FT3 level com-pared with before treatment and the control group had significant increased difference(P <0.05),showing no obvious adverse reactions,and glucose(GLU),triglyceride(TG),cholesterol(CHO)had sharp tenden-cies of declining compared to those before treatments.Conclusion L-carnitine have a significant effect on the treatments of type 2 diabetes mellitus with chronic heart failure.It can improve thyroid function and have no significant adverse reactions.