慢性心力衰竭患者甲状腺激素水平的变化

目的 探讨充血性心力衰竭（CHF）患者血清甲状腺激素水平的改变情况及其与病情的关系.方法 采用放射免疫法测定50例CHF患者（心功能Ⅱ级7例,Ⅲ级19例,Ⅳ级24例）和30例健康人血清三碘甲状腺原氨酸（T3）、四碘甲状腺原氨酸（T4）、游离三碘甲状腺原氨酸（FT3）、游离四碘甲状腺原氨酸（FT4）、促甲状腺激素（TSH）.结果 CHF组T3、FT3含量（1.95±0.55）nmol/L、（2.20±0.39）nmol/L,低于对照组的（2.4±0.50）nmol/L、（5.89±0.45）nmol/L（t=2.415,2.325,P〈0.05）;治疗后T3、FT3含量（2.19±0.53）nmol/L、（3.69±0.57）nmol/L,较治疗前显著升高（t=2.375,2.405,P〈0.05）;CHF心功能Ⅳ级患者T3、FT3含量（1.76±0.7）nmol/L、（1.99±0.45）nmol/L,明显低于对照组（t=2.245,2.375,P〈0.05）;血清TT3、TT4与心功能分级呈负相关（r=-0.933,-0.383,P均〈0.05）,血清FT3、FT4、TSH与心功能分级均无相关性.结论 血清甲状腺激素水平的改变可作为判断CHF严重程度的指标之一.

Change of Thyroid Hormone and its Meaning in Patients with Chronic Heart Failure

Objective To investigate the clinical significance between congestive heart failure (CHF) and serum thyroxine. Methods 50 patients with CHF (7 cases of grade Ⅱ heart function,grade Ⅲ 19 cases,grade Ⅳ 24)and 30 normal persons wre selected. The serum triiodothyronine( T3 ), four-triiodothyronine( T4 ), free triiodothyronine (FT3), free triiodothyronine (FT4), thyroid stimulating hormone TSH were determined by radioimmunoassay. Results The T3, FT3 contens ( 1.95 ± 0.55) nmol/L, (2.20 ± 0.39 ) pmol/L in CHF group were lower than the control group (2.4 ± 0.50) nmol/L, ( 5.89 ± 0. 45 ) pmol/L ( t = 2. 415,2. 325, P < 0.05 ); The T3, FT3 contens ( 2.19 ± 0. 53 )nmol/L,(3.69 ± 0.57)pmol/L after treatment were significantly higher than that before treatment (t =2. 375,2. 405, P < 0.05 ); The T3, FT3 contens in cardiac function with stage Ⅳ ( 1.76 ± 0.7) nmol/L, ( 1.99 ± 0. 45 ) pmol/L were significantly lower than the control group( t = 2.245,2. 375, P < 0.05 ); Serum TT3, TT4 and cardiac function was negatively correlated ( r = -0.933, -0.383, all P < 0.05 ) , serum FT3, FT4,TSH and cardiac function were not correlated. Conclusion The changes of serum thyroid level could be used as an index of the severity of heart failure.