[1]马秀云,郭雅宁,吴会亚,等.超声心动图联合T3、T4检测在缺血性心肌病中医辨证分型中的应用研究*[J].陕西中医,2020,(4):468-470.
点击复制

超声心动图联合T3、T4检测在缺血性心肌病中医辨证分型中的应用研究*
分享到:

《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2020年4期
页码:
468-470
栏目:
临床研究
出版日期:
2020-04-05

文章信息/Info

文章编号:
DOI:10.3969/j.issn.10007369.2020.04.019
作者:
马秀云12郭雅宁12吴会亚12崔英华12马民凯1.2
1.河北省保定市第四中心医院(保定 072350); 2.河北省保定市唐县人民医院(保定 072350)
关键词:
缺血性心肌病 中医证型 甲状腺激素 超声心动图 阳虚血瘀证 阴虚血瘀证
分类号:
R542.2
文献标志码:
A
摘要:
目的:探讨超声心动图联合T3、T4在缺血性心肌病中医辨证分型中的作用。方法:本研究通过对99例缺血性心肌病患者进行中医辨证分型,测定中医各证型组以及正常对照组100例的甲状腺激素水平,包括血浆三碘甲状腺原氨酸(T3)、游离三碘甲状腺原氨酸(FT3)、四碘甲状腺原氨酸(FT3)、游离四碘甲状腺原氨酸(FT4)及促甲状腺激素(TSH),以及99例缺血性心肌病患者的超声心动图指标,包括左房内径(LA)、左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)、左室舒张末期容积(LVEDV)、左室收缩末期容积(LVESV)、左室射血分数(LVEF)。结果:与正常对照组相比较,缺血性心肌病患者组的T3明显降低(P<0.05)。各中医证型组中,T3水平按照阳虚血瘀水停证、阳虚血瘀证、气虚血瘀水停证、阴虚血瘀、气虚血瘀证的顺序增加(均P<0.05)。LVEF按照阳虚血瘀水停证、阳虚血瘀证、气虚血瘀水停证、阴虚血瘀、气虚血瘀证的顺序增加(均P<0.05)。T3水平与LVEF呈高度正相关(r=0.754,P<0.01)。结论:缺血性心肌病患者外周血中T3水平明显降低。T3和LVEF按照阳虚血瘀水停证、阳虚血瘀证、气虚血瘀水停证、阴虚血瘀、气虚血瘀证的顺序明显增加。T3水平与LVEF呈高度正相关。因此,T3与LVEF可以作为缺血性心肌病中医辨证分型的客观指标。

参考文献/References:

[1] Dunlay SM,Pereira NL,Kushwaha SS.Contemporary strategies in the diagnosis and management of heart failure[J].Mayo Clin Proc,2014,89(5):662-676.
[2] Yancy CW,Jessup M,Bozkurt B,et al.ACCF/AHA guideline for the management of heart failure:a report of the American College of Cardiology Foundation/American Heart Association task force on practice guidelines[J].J Am Coll Cardiol,2013,62(16):e147-e239.
[3] Fontana M,Passino C,Poletti R,et al.Low triiodothyronine and exercise capacity in heart failure[J].Int J Cardiol,2012,154(2):153-157.
[4] Pingitore A,Galli E,Barison A,et al.Acute effects of triiodothyronine(T3)replacement therapy in patients with chronic heart failure and low-T3 syndrome:a randomized,placebo-controlled study[J].J Clin Endocrinol Metab,2008,93(4):1351-1358.
[5] Rhee CM,Curhan GC,Alexander EK,et al.Subclinical hypothyroidism and survival:the effects of heart failure and race[J].J Clin Endocrinol Metab,2013,98(6):2326-2336.
[6] Grais IM,Sowers JR.Thyroid and the heart[J].Am J Med,2014,127(8):691-698.
[7] Mitchell JE,Hellkamp AS,Mark DB,et al.Thyroid function in heart failure and impact on mortality[J].JACC Heart Fail,2013,1(1):48-55.
[8] Pantos C,Mourouzis I.Translating thyroid hormone effects into clinical practice:the relevance of thyroid hormone receptor alpha1 in cardiac repair[J].Heart FailRev,2015,20(3):273-282.
[9] Pingitore A,Nicolini G,Kusmic C,et al.Cardioprotection and thyroid hormones[J].Heart Fail Rev,2016,21(4):391-399.
[10] Rajagopalan V,Zhang Y,Ojamaa K,et al.Safe oral Triiodo-L-Thyronine therapy protects from post-infarct cardiac dysfunction and arrhythmias without cardiovascular adverse effects[J].PLoS One,2016,11(3):e0151413.
[11] Pimentel CR,Miano FA,Perone D,et al.Reverse T3 as a parameter of myocardial function impairment in heart failure[J].Int J Cardiol,2010,145(1):52-53.
[12] 屈长宏,王道成.慢性心力衰竭血红蛋白水平与中医证型及临床疗效的关系[J].中国民康医学,2008,20(24):2928-2964.
[13] Biondi B.Mechanisms in endocrinology:heart failure and thyroid dysfunction[J].Eur J Endocrinol,2012,167(5):609-618.
[14] Iervasi G,Nicolini G.Thyroid hormone and cardiovascular system:from basic concepts to clinical application[J].Intern Emerg Med,2013,8(Suppl.1):S71-S74.
[15] Dillmann W.Cardiac hypertrophy and thyroid hormone signaling[J].Heart Fail Rev,2010,15(2):125-132.
[16] Pantos C,Mourouzis I,Saranteas T,et al.Thyroid hormone improves postischaemic recovery of function while limiting apoptosis:a new therapeutic approach to support hemodynamics in the setting of ischaemia-reperfusion? [J] Basic Res Cardiol,2009,104(1):69-77.
[17] Klein I,Ojamaa K.Thyroid hormone and the cardiovascular system [J].N Engl J Med,2001,344(2):501-509.
[18] Ojamaa K,Kenessey A,Klein I.Thyroid hormone regulation of phospholamban phosphorylation in the rat heart [J].Endocrinology,2000,141(6):2139-2144.
[19] Yao J,Eghbali M.Decreased collagen gene expression and absence of fibrosis in thyroid hormone-induced myocardial hypertrophy.Response of cardiac fibroblast to thyroid hormone in vitro [J].Circ Res,1992,71(4):831-839.
[20] Gil-Cayuela C,Rivera M,Ortega A,et al.RNA sequencing analysis identifies new human collagen genes involved in cardiac remodeling [J].J Am Coll Cardiol,2015,65(12):1265-1267.

相似文献/References:

[1]何 钢,郝小鹰.消化性溃疡中医证型胃镜征象特征分析[J].陕西中医,2021,(1):48.[doi:DOI:10.3969/j.issn.1000-7369.2020.01.011]
 HE Gang,HAO Xiaoying.Characteristic analysis of gastroscopy signs of TCM syndromes of peptic ulcer[J].,2021,(4):48.[doi:DOI:10.3969/j.issn.1000-7369.2020.01.011]
[2]吕鸿燕,严兴亚,李 凤,等.缺血性脑卒中患者中医证型与Crouse积分、血清同型半胱氨酸、凝血功能相关性研究[J].陕西中医,2021,(7):879.[doi:DOI:10.3969/j.issn.1000-7369.2020.07.017]
 LYU Hongyan,YAN Xingya,LI Feng,et al.Correlation between TCM syndromes and Crouse score,serum Hcy,coagulation function in patients with ischemic stroke[J].,2021,(4):879.[doi:DOI:10.3969/j.issn.1000-7369.2020.07.017]
[3]王 敏,张金虎.儿童过敏性紫癜中医证型分布规律及治疗方法[J].陕西中医,2021,(8):1068.[doi:DOI:10.3969/j.issn.1000-7369.2020.08.020]
 WANG Min,ZHANG Jinhu.Distribution of TCM syndromes and treatment progress in children with Henoch-schonlein purpura[J].,2021,(4):1068.[doi:DOI:10.3969/j.issn.1000-7369.2020.08.020]
[4]杨 昕,李和根.肺癌辨证分型研究进展[J].陕西中医,2021,(9):1313.[doi:DOI:10.3969/j.issn.1000-7369.2020.09.043]
 YANG Xin,LI Hegen.Progress in syndrome differentiation of lung cancer[J].,2021,(4):1313.[doi:DOI:10.3969/j.issn.1000-7369.2020.09.043]
[5]苏园园,刘宁宁,赖优莹,等.胃癌中医证型研究进展[J].陕西中医,2023,(2):262.[doi:DOI:10.3969/j.issn.1000-7369.2023.02.029]
 SU Yuanyuan,LIU Ningning,LAI Youying,et al.Progress in traditional Chinese medicine syndrome types research of gastric cancer[J].,2023,(4):262.[doi:DOI:10.3969/j.issn.1000-7369.2023.02.029]
[6]毛加荣,刘 稳,芮宏亮,等.IgA肾病107例中医证型与临床、病理及实验室检查相关性分析[J].陕西中医,2023,(9):1231.[doi:DOI:10.3969/j.issn.1000-7369.2023.09.017]
 MAO Jiarong,LIU Wen,RUI Hongliang,et al.Correlation analysis of TCM syndrome types with clinical,pathological and laboratory examination in 107 cases of IgA nephropathy patients[J].,2023,(4):1231.[doi:DOI:10.3969/j.issn.1000-7369.2023.09.017]
[7]何逸俊,魏 华.甲状腺功能亢进患者的中医症型分布特点及与甲功、血脂相关性分析[J].陕西中医,2024,(9):1190.[doi:DOI:10.3969/j.issn.1000-7369.2024.09.008]
 HE Yijun,WEI Hua.The distribution characteristics of TCM syndromes in hyperthyroidism and the correlation analysis with thyroid function and blood lipid[J].,2024,(4):1190.[doi:DOI:10.3969/j.issn.1000-7369.2024.09.008]
[8]邓烟烟,惠振亮,任非非,等.中医论治卒中相关性肺炎研究进展[J].陕西中医,2024,(12):1726.[doi:DOI:10.3969/j.issn.1000-7369.2024.12.031]
 DENG Yanyan,HUI Zhenliang,REN Feifei,et al.Research progress of traditional Chinese medicine on diagnosis and treatment of stroke-related pneumonia[J].,2024,(4):1726.[doi:DOI:10.3969/j.issn.1000-7369.2024.12.031]

备注/Memo

备注/Memo:
*河北省中医药管理局科研计划项目(2016301)
更新日期/Last Update: 2020-04-13