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充血性心力衰竭患者甲状腺激素异常变化及其临床意义
引用本文:谢秀梅,李志凌,戴田娥.充血性心力衰竭患者甲状腺激素异常变化及其临床意义[J].中国现代医学杂志,2004,14(5):42-44,49.
作者姓名:谢秀梅  李志凌  戴田娥
作者单位:1. 中南大学湘雅医院,老干心内科,湖南,长沙,410008
2. 中南大学湘雅医院,心内科,湖南,长沙,410008
3. 中南大学湘雅医院,湖南,长沙,410008
摘    要:目的探讨充血性心力衰竭患者甲状腺激素异常变化及临床意义.方法采用放射免疫法检测了64例充血性心力竭(CHF)患者及28例正常对照者血浆三碘甲状腺原氨酸(T3)四碘甲状腺原氨酸(T4)、反三碘甲状腺原氨酸(rT3)及促甲状腺激素(TSH)的浓度,并对CHF患者作了为期6周的预后观察.结果 CHF患者T3降低,rT3升高,而T4、TSH正常.而且T3越低,T3/rT3比值越小,心功能愈差,预后越差.结论 CHF患者T3 、尤其是T3/rT3比值的变化可作为病情程度及短期预后的判断指标.

关 键 词:充血性心力衰竭  甲状腺激素  正常甲状腺功能病态综合征

Altered thyroid hormone metabolism and clinic significance in congestive heart failure
Abstract.Altered thyroid hormone metabolism and clinic significance in congestive heart failure[J].China Journal of Modern Medicine,2004,14(5):42-44,49.
Authors:Abstract
Abstract:Objective:To determine the prevalence and clinic significance of abnormal thyroid hormone metabolism in congestive heart failure(CHF).Methods:Free triiodothyronine (T 3) index, free thyroxine (T 4) index, reverse T 3 and thyrotropin levels were analyzed by radioimmune assay. 28 normotensive subjects and 64 patients with CHF were evaluated in the study. And the prognoses of CHF were observed for six weeks.Results:Free T 3 index was reduced,reverse T 3 was elevated, but free T 4 index and TSH were normal in all the patients.The lower free T 3 index was,the smaller the free T 3/ reverse T 3 ratio was,the worse the heart function and prognosis were.Conclusions:Free T 3 index and free T 3 index/reverse T 3 ratio can be the strongest predictors for the grade of illness and short-term outcome in patients with CHF.
Keywords:congestive heart failure(CHF)  thyroid hormone  euthyoid sick syndrome (ESS)
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