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左甲状腺素钠与甲状腺素联合治疗甲状腺功能减退所致扩张型心肌病

Combination therapy of liothyronine and levothyroxine for hypothyroidism-induced dilated cardiomyopathy.

作者信息

Choi Youngha, Jung Se Yong, Park Jung Min, Suh Junghwan, Shin Eun Jung, Chae Hyun Wook, Kim Ho-Seong, Kwon Ahreum

机构信息

Department of Pediatrics, Severance Children's Hospital, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, Korea.

Division of Pediatric Cardiology, Department of Pediatrics, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea.

出版信息

Ann Pediatr Endocrinol Metab. 2023 Jun;28(2):144-148. doi: 10.6065/apem.2142218.109. Epub 2022 Jun 20.

Abstract

Thyroid hormone plays a vital role in regulating human metabolism. They affect the functions of major organs, such as the brain, liver, skeletal muscle, and heart. Hypothyroidism can lead to dilated cardiomyopathy and decreased heart function. In this report, we describe a case of a teenage boy who developed dilated cardiomyopathy due to hypothyroidism and was considered to undergo heart transplantation. Levothyroxine monotherapy was initiated but produced no improvement. Thereafter, a combination therapy of liothyronine and levothyroxine was administered, and heart function was gradually restored; he recovered completely after 6 months. Cardiac myocytes respond more specifically to liothyronine than to levothyroxine. Therefore, we suggest that liothyronine and levothyroxine combination therapy should be considered rather than levothyroxine monotherapy for hypothyroidism accompanied by heart disease.

摘要

甲状腺激素在调节人体新陈代谢中起着至关重要的作用。它们影响大脑、肝脏、骨骼肌和心脏等主要器官的功能。甲状腺功能减退可导致扩张型心肌病和心脏功能下降。在本报告中,我们描述了一名青少年男性因甲状腺功能减退而发展为扩张型心肌病并考虑接受心脏移植的病例。开始使用左甲状腺素单一疗法,但未见改善。此后,给予碘塞罗宁和左甲状腺素联合治疗,心脏功能逐渐恢复;6个月后完全康复。心肌细胞对碘塞罗宁的反应比对左甲状腺素更具特异性。因此,我们建议对于伴有心脏病的甲状腺功能减退症,应考虑碘塞罗宁和左甲状腺素联合治疗而非左甲状腺素单一疗法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/974b/10329947/ac6e93c13366/apem-2142218-109f1.jpg

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