甲状腺激素对左室心肌弛张功能的影响及其可能机制

本文用心脏超声及放射免疫法分别检测２０例甲状腺功能亢进症（甲亢）患者予抗甲状腺素治疗前后之心脏弛张功能（ＩＩａ－ＭＶＯ、ｍａｘＲＦＶ、ＰｅａｋＥ、ＰｅａｋＡ、Ｅ／Ａ）、心脏前与后负荷（ＬＶＥＤＶ、ＥＳＳ）、左室收缩力（ＥＳＳ／ＬＶＥＳＶ）及血清Ｔ３和血浆环磷酸腺苷（ｃＡＭＰ）。结果显示：治疗前甲亢组与对照组比较，ＩＩａ－ＭＶＯ明显缩短、ｍａｘＲＦＶ、ＰｅａｋＥ、ＰｅａｋＡ明显增高。甲亢组血浆ｃＡＭＰ、Ｉｌａ－ＭＶＯ、ｍａｘＲＦＶ、ＰｅａｋＥ和Ｅ／Ａ与血清Ｔ３水平有显著的简单相关。血浆ｃＡＭＰ、ＩＩａ－ＭＶＯ、ｍａｘＲＦＶ和ＰｅａｋＥ与Ｔ３有显著偏相关，但ＰｅａｋＥ与Ｔ３之偏相关系数小于年龄及前负荷与Ｔ３之偏相关系数。甲亢组经平均１８０天抗甲状腺素治疗后，其左室舒张功能、血浆ｃＡＭＰ与治疗前比较有显著差异，而与对照组无差异。

INFLUENCE AND POSSIBLE MECHANISM OF THYROID HORMONE ON LEFT VENTRICULAR MYOCARDIAL RELAXATION

Echocardiography and radioimmunoassay were used to study the changes of left ventricular diastolic function(IIa-MVO,Max RFV,peak E,peak A,E/A),preload,afterload,left ventricular contractility(LVEDV,ESS,ESS/LVESV),serum T3,and plasma cAMP of 20 hyperthyroid(HTH) patients before and after antithyroid treatment.The results showed that the HTH group had significantly shorter IIa-MVO and significantly larger Max RFV,peak E,and peak A than those of the control group.Plasma cAMP,IIa-MVO,Max RFV,peak E,and E/A showed significant simple correlation with T3 in the HTH group.Plasma cAMP,IIa-MVO,Max RFV,and peak E showed significant partial correlation with T3,but peak E had a less partial correlation with T3,than with age and LVEDV.HTH group was reexamined after antithyroid treatment for 180 days.Their diastolic indices and plasma cAMP became normal and showed no significant difference with those of the control group.