体外循环心脏手术对甲状腺激素代谢的影响及其临床意义

目的了解体外循环心脏直视手术对甲状腺激素代谢的影响并探讨其临床意义。方法用放射免疫法测定１４例心脏直视手术的血浆甲状腺激素浓度在体外循环中及术后的变化。结果Ｔ３和游离Ｔ３在体外循环最低温度时下降至最低,术后第５天仍低于术前水平（Ｐ＜０．０５）。Ｔ４和游离Ｔ４在术中出现短暂下降,在术后２小时已恢复正常;ＴＳＨ在术后第１、３天比术前下降。２例发生严重并发症,术后第５天Ｔ３和游离Ｔ３仍明显低于同组均值

Thyroid hormone changes after cardiovascular surgery and clinical implications

Objective To define the effect of cardiopulmonary bypass (CPB) on the concentration of thyroid hormone (TH) and metabolites. Methods TH of fourteen cases undergone heart surgery were measured during CPB and postoperative days. Results Serum Triiodothyronine (T3) and free T3 concentration reached their nadir at lowest temperature during CPB, and still lowered than preoperative level in the five days postoperatively. Serum thyroxine (T4) and free T4 returned to preoperative level in two horns after operation. Serum thyroid - stimu-lating hormone decreased at the first three days after operation. Two cases with eventful recovery had lowest T3, fT3 level. Conclusion Low T3, T4 Syndrome was found during CPB, but only Low T3 Syndrome remained five days after operation. The decline of T3 level correlates with the severity of the illness and the prognosis. These data provide further support for clinical trials of T3 supplementation in the prevention or treatment of low cardiac output syndrome.