摘要
目的 研究左旋甲状腺素对老年亚临床甲状腺功能减退症 (甲减 )患者血脂、左心室收缩、舒张功能的影响。 方法 老年亚临床甲减患者 54例随机分为治疗组 28例和对照组 26例。治疗组给予左旋甲状腺素(LT4 )12 5μg/d。对照组未服用有关甲状腺药物。治疗 24周后观察两组治疗前后临床表现、体质量指数 (BMI)、总胆固醇(TC)、甘油三酯 (TG)、载脂蛋白 (ApoA、ApoB)、心电图、左心室射血分数 (LVEF)、左心室短轴缩短率(LVFS)、二尖瓣舒张早期流速峰值(E峰),二尖瓣舒张晚期流速峰值(A峰 ),计算E/A比值等指标的变化。 结果 治疗组临床症状显著改善率 83 9%,对照组 23 4% (P<0 .05);治疗组与对照组比较BMI、TC、TG、ApoB显著降低(P<0 .05);治疗组治疗后LVEF、LVFS指标提高,E/A比值均优于对照组(P<0 05)。2组治疗前后心电图无明显改变。 结论 小剂量LT4 治疗老年亚临床甲减症可使症状改善,血脂降低,左心室收缩、舒张功能提高,而较少发生心肌缺血事件。
Objective To investigate the effect of l-thyroxine(LT 4) on serum lipid, contraction and relaxation of left ventricle in aged patients with subclinical hypothyroidism. Methods 54 elderly patients with subclinical hypothyroidism were randomly divided into therapy group (28 patients) and control group (26 patients). Therapy group took LT 4 (12.5 μg·d -1). Control group (26 patients) didn’t take thyroid drug. After 24 weeks the changes of BMI, TC, TG, ApoA, ApoB, ECG, LVEF, LVFS, earlier flow-rate peak of bicuspid valve relax (E peak), late flow-rate peak of bicuspid, valve relax (A peak), E/A were observed. Results The notable amelioration rates of clinical symptom are 83.9% (therapy group) and 23.4% (control group). BMI, TC, TG and ApoB levels were significantly reduced after the treatment as compared with control group (P<0.05). After treatment , patients in therapy group were better than control group in the rise of LVEF, LVFS level and E/A value (P<0.05). ECG were not notably changed before and after the treatment of both groups. Conclusions The treatment with smaller dosage LT 4 for the aged patients with subclinical hypothyroidism has effects on improving symptom, reducing blood lipid, rising contraction and relaxation of left ventricle, but myocardial ischemia is less common.
出处
《实用老年医学》
CAS
2005年第1期39-41,共3页
Practical Geriatrics
