老年慢性心力衰竭患者甲状腺功能异常的变化规律

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3.熊宝福1

1江西省抚州市第一人民医院老年科,江西抚州 344000;2江西省金溪县第三医院内科,江西金溪 344800;

3江西省中医药高等专科学校附属医院内科,江西抚州 344000

[摘 要 ] 目的 探讨老年慢性心力衰竭(CHF)患者甲状腺功能异常的变化规律. 方法 对100例CHF患者抽取晨间肘静脉血,用放射免疫法测定FT3、FT4及TSH. 结果 老年人CHF甲状腺功能异常患病率39.56%(36/91),甲状腺功能减退(下文中简称:甲减)15.38%(14/91),亚临床甲减24.18%(22/91);且甲状腺功能异常患病率与心衰病程呈正相关(P < 0.001),与心功能程度呈负相关. 结论 对CHF患者常规进行甲状腺功能检测很有必要,可提高甲减性心脏病及CHF合并甲状腺功能异常的正确诊断.CHF合并甲减患者在常规抗心衰治疗基础上补充甲状腺素治疗可以改善心功能.

[关 键 词 ] 慢性心力衰竭;甲状腺功能减退;亚临床甲减

[中图分类号] R541.6 [文献标识码] B [文章编号] 1673—9701(2012)27—0156—03

The variation of abnormal thyroid function in elderly patients with chronic heart failure

YU Yaoming1 XUN Yi2 LI Lan3 XIONG Baofu1

1. Department of Geriatrics,the First People's Hospital of Fuzhou City in Jiangxi Province,Fuzhou 344000,China;2. Department of Internal Medicine,the Third Hospital of Jinxi County in Jiangxi Province,Jinxi 344800,China;3. Department of Internal Medicine,the Affiliated Hospital of Jiangxi Traditional Chinese Medicine College,Fuzhou 344000,China

[Abstract] Objective To investigate the variation of abnormal thyroid function in elderly patients with chronic heart failure(CHF). Methods FT3、FT4 and TSH were detected by radioimmunoassay from 100 patients with CHF in the morning. Results The prevalence of abnormal thyroid function in elderly patients with chronic heart failure(CHF)was 39.56%(36/91), the prevalence of hypothyroidi in that patients was 15.38%(14/91)and the prevalence of subclinical hypothyroidi in that patients was 24.18%(22/91). Furthermore, the correlation between the prevalence of abnormal thyroid function and the duration of heart failure was positive(P < 0.001), while the correlation between the prevalence of abnormal thyroid function and degree of cardiac function was negative. Conclusion It is necessary to do thyroid function examination in patients with chronic heart failure(CHF). It could improve the correct diagnosis of hypothyroidi heart disease and the chronic heart failure bined with abnormal thyroid function. Thyroxine in addition to the conventional treatments may improve the heart function in the patients with chronic heart failure(CHF) and hypothyroidi.


[Key words] Chronic heart failure;Hypothyroidi;Subclinical hypothyroidi

心脏是甲状腺激素重要的靶器官,其通过核内、核外作用直接影响心脏收缩力、节律及外周血管的阻力,体内甲状腺激素水平减低引起心肌原纤维黏液水肿、心肌细胞间质黏多糖、黏蛋白沉积致甲减性心脏病为人熟知[1,2],CHF甲状腺功能异常近年为临床关注.为探讨CHF甲状腺功能改变规律,本研究检测100例60岁以上CHF患者甲状腺功能,对14例合并甲减患者在常规抗心衰治疗基础上加用甲状腺素,自身对照观察临床疗效,以对临床提供参考.

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