肺心病心力衰竭患者血清甲状腺激素测定及其临床意义

Serum levels of thyroxine in patients with cor pulmonale heart failure

目的探讨肺源性心脏病(简称肺心病)心力衰竭患者血清甲状腺激素水平的变化及其临床意义。方法用放射免疫法测定82例肺心病心力衰竭患者和75名正常人血清三碘甲状腺原氨酸(T3)、四碘甲状腺原氨酸(T4)、游离T(3FT3)、游离T4(FT4)、促甲状腺激素(TSH)。结果轻度肺心病心力衰竭患者T3(1.01±0.21)nmol/L、T4(89.92±22.01)nmol/L、FT3(2.80±0.30)pmol/L、FT(411.39±2.99)pmol/L、TSH(1.44±0.38)mU/L与对照组T(31.05±0.20)nmol/L、T(490.01±21.38)nmol/L、FT(32.81±0.28)pmol/L、FT(411.42±2.71)pmol/L、TSH(1.40±0.40)mU/L比较差异均无统计学意义(t=0.84、0.017、0.14、0.045、0.42,均P>0.05)。重度肺心病心力衰竭患者T(30.61±0.19)nmol/L与对照组比较明显降低(t=8.83,P<0.05),T4(88.97±21.20)nmol/L、FT(32.76±0.32)pmol/L、FT(411.27±2.76)pmol/L、TSH(1.39±0.39)mU/L与轻度肺心病患者比较差异均无统计学意义(t=0.14、0.46、0.13、0.42,均P<0.05),治疗后心力衰竭减轻时T(31.02±0.28)nmol/L明显升高(t=5.34,P<0.05)。结论血清T3水平的改变对判断肺心病心力衰竭患者的预后、严重程度和疗效有一定的指导意义。

Objective To investigate serum levels of thyroixine in patients with cor pulmonale heart failure and its clinical significance. Methods Eighty two patients with cor pulmonale heart failure and 75 healthy controls were enrolled in the study. Serum levels of triiodothyronine （T3）, thyroxine （T4）, free T3 （FT3）, free T4 （FT4） and thyroid-stimulating hormone （TSH） were determined by radioimmunoassay. Results In the advanced cases of cor pulmonale heart failure, serum T3 levels were significantly reduced compared with normal controls （0.61 ± 0.19nmol/L vs 1.05 ± 0.20 nmol/L, t=8.83, P 〈 0.05）, which were raised markedly after successful treatment （ 1.02 ± 0.28nmol/L, t=5.34, P 〈 0.05）. Conclusion Serum T3 levels may serve as an index for severity and therapeutic efficacy of heart failure in patients with cor pulmonale.