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充血性心力衰竭患者血清甲状腺激素水平改变及其临床意义(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
1998年第4期
页码:
230-231,235
栏目:
论著
出版日期:
1998-07-01

文章信息/Info

Title:
The change of thyroid hormone in patients with congestive heart failure and its significance
作者:
李闽云　杨欣国　郑强荪　柳 荫　褚西秦
第四军医大学唐都医院心内科 西安710038
Author(s):
Li Minyun;  Yang Xinguo;  Zheng Qiangsun; Liu Yin;  Chu Xiqin
Department of Cardiology, Tangdu Hospital, Fourth Military Medical University, Xi′an 710038
关键词:
心力衰竭;  充血性　甲状腺激素　心功能　射血分数
Keywords:
heart failure;  congestive　thyroid hormone　heart function　ejection fraction
分类号:
-
DOI:
-
文献标识码:
-
摘要:
为观察充血性心力衰竭(CHF)患者血清甲状腺激素的改变, 并探讨这些改变与CHF患者病情及预后的关系, 以NYHA心功能分级标准分类心衰等级, 用放射免疫法测定血清甲状腺激素水平, 并与对照组比较。结果:三碘甲状腺原氨酸(T3) 降低(1.69±0.68, P < 0.05) , 游离三碘甲状腺原氨酸(FT3) 降低(5.53±2.01, P < 0.05) ,反三碘甲状腺原氨酸( rT3) 增高(0.68±0. 13, P < 0.01) ; 不同心功能级别的CHF患者血清甲状腺激素水平比较,心衰愈重则甲状腺激素改变愈明显; 心室射血分数(EF)值与FT3呈正相关( r= 0.433, P < 0.01) , 与rT3呈负相关(r= - 0.606, P < 0.01)。提示: CHF患者存在继发性甲状腺激素代谢异常, FT3降低和rT3升高可作为CHF患者病情和预后判断的指标。
Abstract:
To observe the change of serum level of thyroid hormone in patients with congestive heart failure (CHF) and to study the relation between state of the illness and altered serum thyroid hormone, the patients (48 cases) were classified with heart failure class criteria of NYHA and serum thyroid hormone level was measured with radio immunoassay. The results were compared with control subjects (24 cases). It was shown that the level of serum triiodothyronine (T3) lowered (1.69±0.68, P < 0.05) and so did that of free triiodothyronine (FT3) (5.53±2.01, P < 0.05) , but the level of reverse triiodothyronine (rT3) elevated (0.68±0.13, P < 0.01). It was also shown that the worse the state of heart function in patients with CHF, the more marked the alteration of thyroid hormone and that the left ventricular ejection fraction (LVET) in patients with CHF was positively correlated with FT3 (r= 0.433, P < 0.01) and negatively correlated with rT3(r=- 0.606, P < 0.01). These results suggested that the secondary abnormal thyroid hormone metabolism existed in patients with CHF, the low serum level of FT3and the elevated serum level of rT3might be used as the variables in evaluating the state of the illness and estimating the prognosis in patients with CHF.

参考文献/References

［1］Utiger RD. Altered thyroid function in nonthyroidal illness and surgery: to treat or not to treat. N Engl J Med , 1995; 333: 1562.

［2］ Cinochowski GE, Harostock MD, Foldes PI. Minimal operative mortality in patients undergoing coronary artery bypass with significant left ventricular dysfunction by maximization of metabolic and mechanical support. J thorac cardiovasc surg , 1997; 113: 655.

［3］Ladenson PW , Kieffer JD, Farwell AP, et al. Modulation of myocardial 1-triiodothyronine receptors in normal, hypothyroid, and hyperthyroid rats. Metabolism , 1986; 35: 5.

［4］Chopra IJ , Hershman JM , pardridge WM , et al. Thyroid function in nonthyroidal illness. Ann Intern Med , 1983; 98: 946.

［5］Kohno M ,Muradawa K, Yasunari K, et al. Circulating atrial natriuretic peptides in hyperthyroidism and hypothyroidism. Am J Med , 1987; 87: 648.

备注/Memo

备注/Memo:
(收稿1998-06-30　修回1998-08-25)
更新日期/Last Update: 1998-07-01