摘要
目的探讨对老年蛋白质-能量营养不良合并正常甲状腺功能病态综合征患者应用小剂量甲状腺激素治疗后改善血红蛋白和白蛋白水平的有效性及安全性。方法选取自2017年1月1日-2021年8月31日在某院住院年龄≥65岁,同时符合低蛋白血症、贫血和正常甲状腺病态综合征的老年患者65例,将患者随机分为治疗组35例和对照组30例。两组患者均给予大于20大卡/公斤/体重每日的热量,蛋白质0.8g/kg/体重每日,常规原发病治疗。治疗组在常规营养治疗和原发病治疗的基础上加用小剂量左甲状腺素钠25ug/d,治疗3个月。观察治疗前后甲状腺功能,血红蛋白,血白蛋白,前白蛋白,静息心率等变化。结果与对照组相比,治疗前二组在HB、ALB和PAL水平及甲状腺功能上无显著差异(P>0.05)。与对照组相比,应用小剂量左甲状腺素钠补充治疗3个月后,治疗组血红蛋白(112.6±13.3)g/l,前白蛋白(173.3±55.1)mg/l,FT4(1.51±0.23)g/dl均有升高,组间有统计学差异(P<0.05),两组心率比较无统计学差异。结论在老年蛋白质-能量营养不良合并甲状腺功能病态综合征患者常规治疗基础上给予小剂量左甲状腺素片可升高血红蛋白及白蛋白水平,且对心率无明显影响,但还需要扩大临床样本数据进一步确证。
Objective To observe the efficacy and safety of low Dose Levothyroxine on improving hemoglobin and albumin levels in elderly patients with protein-energy malnutrition and euthyroid sick syndrome.Methods A total of 65 elderly patients aged over 65 years old who were admitted to a hospital from January 1st,2017 to August 31st,2021 with hypoproteinemia,anemia and normal thyroid syndrome were selected,and the patients were randomly divided into the treatment group(35 cases)and the control group(30 cases).Both groups were given more than 20kcal/kg/body weight daily calories,0.8g/kg/body weight protein daily,conventional primary disease treatment.In the treatment group,a small dose of levothyroxine sodium 25ug/d was added on the basis of conventional nutritional treatment and primary disease treatment for 3 months.The changes of thyroid function,hemoglobin,blood albumin,prealbumin and resting heart rate were observed before and after treatment.Results Compared with the control group,there were no significant differences in HB,ALB and PAL levels and thyroid function between the two groups before treatment(P>0.05).Compared with the control group,after 3 months of low-dose levothyroxine sodium supplementation,hemoglobin(112.6±13.3)g/l,prealbumin(173.3±55.1)mg/l,FT4(1.51±0.23)g/dl were increased in the treatment group,and there were statistical differences between the groups(P<0.05).There was no significant difference in heart rate between the two groups.Conclusions On the basis of routine treatment in elderly patients with protein-energy malnutrition combined with thyroid dysfunction syndrome,low-dose levothyroxine tablets could increase the levels of hemoglobin and albumin,and had no significant effect on heart rate,but it needed to be further confirmed by expanding clinical sample data.
作者
邬静娜
蔡松
易旭
王佳宁
Wu Jingna;Cai Song;Yi Xu;Wang Jianing(不详;Department of Cardiology,Beijing Longfu Hospital,Beijing 100010,China)
出处
《中国病案》
2024年第8期106-109,共4页
Chinese Medical Record
