慢性心力衰竭患者甲状腺激素水平变化的相关研究

【目的】探讨慢性心力衰竭（CHF）患者血清甲状腺激素水平的变化特点，以及合并正常甲状腺功能病态综合征（ESS）患者的血浆脑钠肽（BNP）水平变化。【方法】选取CHF患者104例（NYHAⅡ级38例，Ⅲ级40例，Ⅳ级26例），对照组（NYHAⅠ级）23例，分别测定血清T3、FT3、T4、FT4、TSH、BNP、左室射血分数（LVEF），比较ESS组和非ESS组之间BNP、LVEF等指标变化。【结果】①不同心功能组T3、FT3、T4、FT4水平随心功能不全的加重而下降，ESS发生率依次升高；②CHF合并ESS患者BNP明显升高，LVEF下降、LVEDD扩大、心率增快。【结论】CHF合并ESS患者，心肌结构和神经内分泌系统改变更严重。

Study on the Changes of Serum Thyroid Hormone Levels in Patients with Chronic Heart Failure

Objective] To investigate the changes of serum thyroid hormone in patients with chronic heart failure （CHF） and the plasma brain natriuretic peptide （BNP） in CHF patients with euthyroid sick syndrome（ESS）. Methods] The study population included 104 patients with chronic heart failure（NYHAⅡ38 cases, NYHA Ⅲ 40 cases and NYHA Ⅳ 26 cases）and 23 patients （NYHA Ⅰ） with chronic cardiovascular disease. Levels of BNP, serum T3, FT3, T4, FT4, TSH, end diastolic diameter（LVEDD） and ejection fraction（LVEF） of left ventricle were measured. BNP and LVEF between the ESS group and non-ESS group were compared. Results] The levels of T3, FT3, T4 and FT4 decreased as the degree of chronic heart failure increased, while the prevalence of ESS increased. The levels of BNP, LVEDD and heart rate increased while LVEF decreased as the degree of chronic heart failure increased in ESS group. Conclusion]Changes of myocardial structure and the neuroendoerine system are more serious in patients with chronic heart failure and ESS.