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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。
Objective: To investigate the clinical effect of antithyroid drugs (methimazole) on heart failure in patients with heart failure (heart failure) and subclinical hyperthyroidism (subclinical hyperthyroidism). Methods: From July 2009 to May 2011, 86 patients with heart failure complicated with subclinical hyperthyroidism were randomly divided into 2 groups. The treatment group (n = 43) was given conventional anti-heart failure drug therapy based on the addition of methimazole (10 mg once daily orally). The control group (n = 43) was given anti-heart failure medication and was followed up for 6 months. The plasma NT-proBNP level was measured by immunofluorescence method. The heart structure and function were detected by ViVid7 cardiac colorimeter of GE Company. Free triiodothyronine (FT3), free thyroxine (FT4) and thyrotropin (TSH) ). Results: There was no significant difference between the two groups in the basic clinical data and the basic anti-heart failure medication. Compared with the control group, the left atrium area (LA), left ventricular area (LV), ejection fraction (EF), plasma NT-proBNP and cardiac function in the treatment group were not significantly different Monthly rehospitalization rate was no significant difference (P> 0.05). However, the recurrence rate of atrial fibrillation (AF) (P <0.05) and the new incidence of atrial fibrillation were significantly lower (P <0.05). Conclusion: Anti-thyroid drug treatment in patients with heart failure and subclinical hyperthyroidism can significantly reduce the new incidence of atrial fibrillation and recurrence of atrial fibrillation.