慢性心力衰竭患者甲状腺激素水平变化的临床观察

目的探讨慢性充血性心力衰竭患者(CHF)甲状腺激素水平的变化及临床意义。方法采用放射免疫法测定30例体检正常者和50例慢性心力衰竭患者心衰治疗前后的血浆三碘甲状腺原氨酸(T3)、甲状腺素(T4)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)及促甲状腺素(TSH)水平。比较两组间的差异,并对CHF患者进行亚组分析。结果CHF组T3、FT3较对照组下降,且慢性心衰组随着心力衰竭的加重,T3、FT3水平逐渐减低;T4、FT4、TSH两组间比较无显著差异,抗心衰治疗后T3、FT3水平明显上升(P<0.05)。慢性心衰组患者血清中T3、FT3的水平与心衰程度呈负相关关系。结论CHF患者甲状腺激素水平的变化,对判断其心功能损害程度和预后具有一定的临床意义。

Observation of Thyroid Hormone Level in Chronic Heart Failure Paitents

Objective To determine the level and significance of abnormal thyroid hormone metabolism in congestive heart failure. Method The levels of Tetra-iodothyronine(T4), free thyroxine (FT4), tri-iodothyronine(T3),free tri-iodothyronine (FT3) and thyrotropin (TSH) from 50 hospitalized patients with chronic heart failure and 30 healthy control subjects were determined by Radioimmunoassay RIA. The difference was compared between these two groups. Result The levels of T4, FT4, and TSH were normal in all patients. The index of T3 and FT3 was reduced in CHF paitents. After therapy, the concentration of T3 and FT3 was increased to a level as before the treatment(P < 0.05). In CHF patients, the levels of T3 and FT3 showed a negative correlation with the degree of CHF. Conclusion The thyroid hormone level has a prognostic value in CHF patients and can be used as an indicator in accessing the cardiac dysfunction.