血清甲状腺激素水平与收缩性心力衰竭的相关性探讨

目的探讨血清甲状腺激素水平与收缩性心力衰竭（CHF）的相关性。方法采用放射免疫分析法检测83例CHF患者（CHF组）治疗前后血清游离三碘甲状腺原氨酸（FT3）、游离甲状腺素（FT4）和促甲状腺激素（TSH）水平,同时采用多普勒超声心动图测定患者心力衰竭纠正前后卧位时的左室射血分数（LVEF）。并与33例健康体检者（对照组）上述指标进行比较分析。结果心功能Ⅱ、Ⅲ、Ⅳ级的CHF患者血清FT3水平均显著低于对照组,差异均有统计学意义（P〈0.01）;CHF患者血清FT3水平随着NYHA心功能分级的加重而逐渐降低（P〈0.01或P〈0.05）。48例CHF患者心力衰竭得到纠正后,血清FT3水平和LVEF均较治疗前明显升高（P〈0.01）。结论 CHF患者FT3水平下降,且心力衰竭越严重,FT3降低越明显。监测CHF患者FT3水平可作为评价病情轻重、治疗效果及预后的一项指标。

Correlation between levels of serum thyroid hormone and congestive heart failure

Objective To inquire the correlation between levels of serum thyroid hormone and congestive heart failure（CHF）.Methods Serum FT3,FT4 and TSH were measured by radioimmunoassay,and LVEF was measured by Doppler echocardiography in 83 patients with CHF before and after heart failure was corrected.And comparative analysed these indicators of 33 cases of healthy subjects（control group）.Results Compared with control group,the serum levels of FT3 in patients with cardiac function grades at stageⅡ,Ⅲ and Ⅳ were decreased significantly（P0.01）.The level of serum FT3 gradually dropped with aggravation of NYHA cardiac function grades（P0.01 or P0.05）.After heart failure was corrected,the level of serum FT3 and LVEF in 48 CHF cases were increased significantly（P0.01）.Conclusion The levels of serum FT3 in CHF patients drop,and the more poorer the heart failure,the more lower the level of serum FT3.Therefore,the level of serum FT3 of may be used as an index of severity,therapeutic effect and prognosis of heart failure in CHF patients.