Objective To investigate the effect of chronic heart failure (CHF) in patients with abnormal serum thyroxine and low dose of levothyroxine on cytokines and clinical efficacy. Methods 40 patients with CHF from June 2013 to November 2014 in Dongcheng Hospital of Dongguan City were divided into two groups by randomized parallel con-trolled method, 20 cases in each group. Two groups of patients were given the strong heart, diuresis, same vasodilator drug therapy, based on the plus service, the treatment group was given levothyroxine sodium (euthyrox) 12.5μg/d, for 2 weeks. The two groups before and after treatment of three serum free triiodothyronine (FT3), free thyroxine (FT4), anti-three triiodothyronine (rT3), tumor necrosis factorα (TNF-α) and serum interleukin 6 (IL-6) level were detected; at the same time left ventricular ejection fraction drawing instrument (LVEF) level changes were detected by beckoning ultra-sonic and correlation analysis was given. Results The levels of LVEF and FT3 after 2 weeks of treatment in two groups increased, the levels of rT3, TNF-α, IL-6 decreased in different degree. Compared with the control group, the treatment group significantly increased the number of FT3 with significant difference[(4.01±0.52) pmol/L vs (3.12±0.36) pmol/L, P<0.05], LVEF increased more significantly [(39.1±8.3)% vs (29.6±8.5)%, P< 0.05], decrease the number of TNF alpha, IL-6 levels [(20.89±8.83) μg/L vs (25.56±10.52) μg/L, (60.12±21.05) ng/L vs (70.06±22.28) ng/L, P<0.05)]. Conclu-sion CHF in patients with serum thyroid hormone function is in the low level, and the cytokines TNF-α, IL-6 are at a higher level. Left thyroid sodium through the regulation of the cytokine levels, can prevent and reverse ventricular re-modeling and improve cardiac function, with auxiliary therapy better on CHF.%目的：探讨慢性心力衰竭（CHF）患者体内血清甲状腺激素异常情况及小剂量左甲状腺素钠对细胞因子水平的影响和临床疗效。方法采用随机、平行对照方法将40例广东省东莞市东城医院2013年6月~2014年11月CHF患者分为两组，每组20例。两组患者给予相同的强心、利尿、扩张血管等药物基础治疗，治疗组在此基础上加服左甲状腺素钠（优甲乐）12.5μg/d，疗程均为2周。检测两组治疗前后血清游离三碘甲状腺原氨酸（FT3）、游离甲状腺素（FT4）、反三碘甲状腺原氨酸（rT3）、肿瘤坏死因子α（TNF-α）和血清白介素6（IL-6）的水平；同时采用超声心动图仪检测左室射血分数（LVEF）水平变化并进行相关性分析。结果经过2周治疗后两组患者LVEF和FT3的水平均增加，rT3、TNF-α、IL-6的水平均有不同程度降低。与对照组比较，治疗组FT3显著增加，差异有统计学意义[（4.01±0.52）pmol/L比（3.12±0.36）pmol/L，P<0.05]，LVEF增加亦显著，差异有统计学意义[（39.1±8.3）%比（29.6±8.5）%，P<0.05]，TNF-α、IL-6的水平降低幅度亦明显，差异均有统计学意义[（20.89±8.83）μg/L比（25.56±10.52）μg/L，（60.12±21.05）ng/L比（70.06±22.28）ng/L，均P<0.05]。结论 CHF患者体内血清甲状腺素功能处于较低水平，而细胞因子TNF-α、IL-6又处于较高的水平。左甲状腺素钠通过调控上述细胞因子水平，起到防止和逆转心室重构、改善心功能，对CHF起到较好的辅助治疗。
展开▼
