甲状腺功能异常患者心肌酶变化的分析

为了解原发性甲状腺功能减退症（甲减）患者和甲状腺功能亢进（甲亢）患者心肌酶的变化,检测了20例原发性甲减患者、27例甲亢患者以及30例健康体检者（对照组）的空腹血清天门冬酸氨基转移酶（AST）、肌酸激酶（CK）及其同工酶（CK-MB）、乳酸脱氢酶（LDH）及其同工酶（HBDH）、FT3、FT4、TSH、总胆固醇（Tch）。结果显示,原发性甲减患者AST、CK、CK-MB、LDH、HBDH及Tch均明显高于对照组（P分别〈0.01、0.01、0.01、0.01、0.05、0.01）;TSH和FT4与心肌酶、Tch均无相关性;FT3与CK、CK-MB负相关（r=-0.53,-0.47,P均〈0.05）,与Tch呈负相关（r=-0.504,P〈0.05）;甲亢患者血清CK-MB明显高于对照组（P〈0.01）,且血清FT4与CK-MB呈显著正相关（r=0.462,P〈0.01）。结论：原发性甲减患者和甲亢患者常伴心肌酶升高,其中甲减者FT3水平与CK、CK-MB、Tch升高关系更密切。

Changes of Myocardial Enzymes in Patients with Primary Hypothyroidism and Hyperthyroid

To investigate the relationship between thyroid function and myocardial enzymes in patients with primary hypothyroidism and hyperthyroid, the serum levels of aspartate aminotransferase （AST）, creatinekinase （CK） and its isoenzyme（ CK-MB）, lactate dehydrogenase （LDH） and its isoenzyme （ HBDH）, free triiodothyronine （ FT3 ）, free thyroxin （ FT4 ）, thyrotropin （ TSH）, and total cholesterol （Tch） in 20 patients with primary hypothyroidism, 27 patients with hyperthyroidism and 30 healthy controls were measured. The results showed that the serum levels of AST, CK, CK-MB, LDH, HBDH and Tch in primary hypothyroidism were significantly higher than that of in healthy control. The serum levels of TSH and FT4 had no relation with myocardial enzymes and Tch in patients with primary hypothyroidism, but the serum FT3 was negatively related with CK, CK-MB and Tch. The serum CK-MB level in patients with hyperthyroid was significantly higher than that in healthy contnols （ P 〈 0.01 ）, and serum FT4 was positively related with CK-MB. The results indicated that myocardial enzymes in patients with hypothyroidism and hyperthyroid were increased, the lower level of FT3 in patients with primary hypothyroidism was responsible for the higher levels of CK, CK-MB and Tch.