老年慢性心力衰竭患者心功能与血清甲状腺激素、血浆N末端原脑利钠肽的变化及对预后的影响

Study on changes in blood levels of thyroid hormones and N-terminal pro-brain natriuretic peptide and its influence on prognosis of elderly patients with congestive heart failure

目的:探讨老年慢性心力衰竭患者心功能与血清甲状腺激素、血浆N末端原脑利钠肽的变化及对预后的影响。方法:选择80例老年慢性心力衰竭患者,根据心功能分级分为2组,分别测定血浆N末端原脑利钠肽(NT-proBNP)、血清三碘甲状腺氨酸(T3)、甲状腺素(T4)、游离三碘甲状腺氨酸(FT3)、游离甲状腺素(FT4)及促甲状腺素(TSH)水平。比较2组间甲状腺激素水平变化及NT-proB-NP的变化。结果:心功能Ⅳ级患者与心功能Ⅱ级、Ⅲ级患者比较,T3和FT3明显降低,差异具有统计学意义,P<0.05。NT-proBNP随着心功能不全加重而升高,两组相比差异具有统计学意义,P<0.05。而T4、FT4、TSH均无明显变化,差异无统计学意义,P>0.05。结论:甲状腺激素、NT-proB-NP与老年慢性心力衰竭患者的心功能严重程度有关,影响预后。

Objective. To study the changes in blood levels of thyroid hormones and N-terminal pro-brain natriuretic peptide and its influence on prognosis of elderly patients with congestive heart failure. Methods. A total of 80 elderly patients with congestive heart failure were divided into two groups according to the grade of function of heart. Blood levels of NT-proBNP,T3,T4,FT3,FT4 and TSH were measured in these patients. Results. The blood levels of T3 and FT3 were significantly decreased in elderly patients with grade 1V congestive heart failure compared with those of patients with grade Ⅲ-If congestive heart failure （P〈0.05）. Blood level of NT-proBNP increased with the severity of chronic heart failure （P〈 0.05）. But no significant difference in T4, FT4 and TSH were observed （P〈0.05）. Conclusion. Blood levels of thyroid hormones and NT-proBNP were related wtih severity of cardiac dysfunction in elderly pa- tients with congestive heart failure, it affects prognosis.