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随着心力衰竭患者的住院率及死亡率逐年增长,国内外学者越来越关注甲状腺激素在心力衰竭的发生发展中的作用。正常的甲状腺激素水平对于维持心脏正常收缩和舒张功能至关重要。近年来研究发现,慢性心力衰竭患者普遍存在正常甲状腺功能病态综合征,即游离三碘甲状腺原氨酸(FT3)、三碘甲状腺原氨酸(T3)降低,或者FT3、T3及游离甲状腺素(FT4)、四碘甲状腺原氨酸(T4)均降低,反三碘甲状腺原氨酸(r T3)升高,而血清促甲状腺激素(TSH)正常,在这种病理状态下,心力衰竭进一步恶化,进入恶性循环。故监测血清甲状腺激素水平,有益于评估心力衰竭患者病情严重程度及预后,对于伴有正常甲状腺功能病态综合征的心力衰竭患者可在常规治疗心力衰竭的基础上加用小剂量短疗程的甲状腺激素治疗,这有利于患者心功能的恢复。
With the increasing incidence of hospitalization and mortality in patients with heart failure, scholars both at home and abroad pay more and more attention to the role of thyroid hormones in the occurrence and development of heart failure. Normal thyroid hormone levels are essential for maintaining normal systolic and diastolic cardiac function. In recent years, studies have found that in patients with chronic heart failure prevalence of normal thyroid function sick syndrome, namely free triiodothyronine (FT3), triiodothyronine (T3) decreased, or FT3, T3 and free thyroxine FT4) and tetraiodothyronine (T4) were both decreased, and elevated anti-triiodothyronine (rT3) and normal serum thyrotropin (TSH), which further worsened heart failure in this pathological condition , Into a vicious circle. Therefore, monitoring serum thyroid hormone levels, beneficial to assess the severity and prognosis of patients with heart failure, heart failure patients with normal thyroid function sick syndrome in conventional treatment of heart failure can be based on the use of small doses of short courses of thyroid hormone Treatment, which is conducive to the recovery of patients with cardiac function.