扩张型心肌病血清甲状腺激素水平与心功能的相关性研究

Correlation between thyroid hormone and cardic function in dilated cardiomyopathy

目的 探讨扩张型心肌病 (DCM)患者血清甲状腺激素 (TH)水平变化规律及其与心功能的相关性。方法 采用放射免疫分析法测定 4 3例DCM病人和 4 0例健康对照组血清TH浓度 ,同时用后前位X线胸片测心胸比例 ,超声心动图测定左室射血分数 (LVEF)。结果 游离三碘甲状腺原氨酸 (FT3 )降低 ,反三碘甲状腺原氨酸 (rT3 )增高 ,DCM患者血清TH水平随充血性心衰 (CHF)的加重而降低。心胸比例与FT3 呈负相关 ,与rT3 呈正相关 ;LVEF与FT3 呈正相关 ,与rT3 呈负相关。结论 血清FT3 降低和rT3 增高可作为反映CHF严重程度的敏感指标之一 ,FT3 可能参与DCM的发生发展和演变。

Objective To investigate the change of serum level of thyroid hormone(TH) in patients with dilatecd cardiomyopathy(DCM) and the correlation between thyroid hormone and cardiac function.Methods Serum TH level were measured with radioimmunoassay in 43 patients with DCM and 40 healthy control subjects. The heart-thorax ratios were measured with x rays and left ventricular ejection fraction(LVEF) was obtained by echocardiography.Results The level of serum free triiodothyronine(FT 3) was significantly reduced, but the level of reverse triiodothyronine (rT 3) elevated.The decrease of serum levels of TH in patients with DCM closely was correlated with the severity of symptoms of congestive heart failure(CHF).Heart-chest ratio in patients with DCM was negatively correlated with FT 3 and positively correlated with rT 3. The LVEFin patients with DCM was positively correlated with FT 3 and negatively corrdlated with rT 3.Conclusion In patients with DCM,the low serum level of FT 3 and the elevated serum level of rT 3 might be used as one of sensitive indicators in reflecting the severity of CHF. FT 3 may be involved in progress of DCM.