【摘要】 目的:探讨心力衰竭(心衰)合并亚临床甲状腺功能亢进(亚临床甲亢)患者应用抗甲状腺药物(他巴唑)治疗对心衰的临床疗效。方法:2009年7月～2011年5月,入选心衰合并亚临床甲亢患者86例,随机分为2组,治疗组(n=43)给予常规抗心衰药物治疗基础上加用他巴唑(每天10mg1次口服)。对照组(n=43)给予抗心衰药物治疗,随访6个月。应用免疫荧光法测定血浆NT-proBNP,美国GE公司ViVid7心脏彩色超声仪检测心脏结构和功能,常规法检测游离三碘甲状腺原氨酸(FT3),游离甲状腺素(FT4)和促甲状腺激素(TSH)。结果:2组患者在临床基本资料和抗心衰基础用药方面没有显著差异。治疗组与对照组相比患者左房面积(LA),左室面积(LV),射血分数(EF值),血浆NT-proBNP,心功能无统计学差异(P>0.05),随访6个月再入院率也无统计学差异(P>0.05)。但是心房纤颤(房颤)复发率(P<0.05)和心房纤颤新发生率显著降低(P<0.05)。结论:心衰合并亚临床甲亢患者应用抗甲状腺药物治疗可以显著减少房颤新发生率及房颤复发。更多还原

【Abstract】 Objective:To investigate the clinical effects of antithyroid drugs on patients with heart failure and subclinical hyperthyroidism. Methods: From July 2009 to May 2011, eighty six patients with heart failure and subclinical hyperthyroidism were randomly divided into two groups, the treatment group (n=43) in which patients were given methimazole for 10 mg daily in addition to drugs for heart failure treatments, the control group (n=43) in which patients were given drugs for heart failure therapy only.All patients were followed up for 6 months. The plasma levels of NT-proBNP were measured by immunohistochemical staining . Transthoracic echocardiographic examinations were performed to detect structural and functional changes of atrium and ventricular. Finally, the plasma levels of free triiodothyronine(FT3), free thyroxine (FT4)and thyroid stimulating hormone(TSH) were routinely measured.Result: There is no significant difference between the two groups of patients about clinical characteristics. Compared with the control group, in the treatment group the left atrial size (LA), area of left ventricular (LV), EF, plasma NT-proBNP, cardiac function shows no significant improve (P>0.05) during 6 months follow-up. However, atrial fibrillation recurrence rate (P<0.05) and the new occurrence of atrial fibrillation (P<0.05) significantly reduced in the treatment group compared with the control group. Conclusion:The treatment with antithyroid drug in patients with heart failure and subclinical hyperthyroidism can reduce the new occurrence and recurrence of atrial fibrillation.更多还原