慢性心功能不全患者血清甲状腺激素水平变化的临床研究

Clinical study on serum thyroid hormones in patients with chronic heart failure

目的:观察慢性心功能不全(CHF)患者血清甲状腺激素水平的变化,探讨其与CHF的关系。方法:用化学发光法测定120例心功能Ⅱ～Ⅳ级患者(心衰组),70例心功能正常患者(对照组)血清甲状腺激素(游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、总三碘甲状腺原氨酸(T3)、总甲状腺素(T4)、促甲状腺素(TSH)水平及左心室射血分数(LVEF),并进行比较分析。结果:心衰组患者血清FT3、T3、T4、LVEF水平明显低于对照组,FT3、FT4、T3、T4在心功能达Ⅲ～Ⅳ级时明显降低,且与LVEF相关,差异有统计学意义(P<0.01)。结论:甲状腺功能正常性病变综合征(SES)的发生率与心功能分级有关,心衰越严重,降低越明显,甲状腺激素水平的变化可评估CHF的程度,对心功能患者病情及预后判断均有价值。

Objective：To observe the changes of serum thyroid hormone in patients with chronic heart failure（CHF） and to define its relationship with CHF.Methods：Chemiluminescence methord was applied to determine the serum thyroid hormone（FT3,FT4,T3,T4,TSH and LVEF） in 120 class II to IV CHF patients（heart failure group） and 70 normal subjects（control group）,the serum level was compared and analysed.Results： The FT3,T3,T4 and LVEF levels in CHF patients are significantly lower than the control group,the FT3,FT4,T3 and T4 levels decreased apparently when the CHF clase is III or IV,and is related to the LVEF,the difference has statistical sense（P0.01）.Conclusion： The incidence of sick euthyroid syndrome（SES） is correlated with the degree of the heart failure,the worse the heart failure is,the more significant the serum level decrease.The serum thyroid hormone change is helpful in evaluating the severity and prognosis of patients with CHF.