血脂和甲状腺激素水平测定在冠心病心力衰竭严重程度诊断中的临床研究

Clinical Study of Severity Diagnosis through Determining Blood Lipid and TH Levels in Patients with Heart Failure of CHD

目的探讨血脂和甲状腺激素水平测定在冠心病（CHD）心力衰竭严重程度诊断中的临床应用.方法采用生化法和化学发光免疫分析测定136例CHD心力衰竭患者和36例急性心肌梗死（AMI）患者的血脂和血清甲状腺激素（TH）水平并与60名正常对照组进行比较分析.结果 CHD心力衰竭患者血清TC、TG和LDL-C水平较之正常对照组明显增高（P均〈0.05）,并随心力衰竭的严重程度而降低,血清HDL-C水平稍降低与正常对照组无明显差异（P〉0.05）,也随心力衰竭的严重程度而降低,AMI患者血脂指标均降低（P均〈0.05）.在TH分析中,CHD心力衰竭患者血清T3和FT3的水平较之正常对照组明显降低（P均〈0.05）,并随心力衰竭的严重程度而降低, AMI患者血清T3和FT3水平为最低,CHD心力衰竭和AMI患者的血清T4、FT4和TSH水平较之正常对照组无明显差异（P均〉0.05）.结论 CHD心力衰竭患者血脂代谢紊乱,血清TC、TG和LDL-C明显增高,而T3和FT3明显降低,血脂和TH水平均随CHD心力衰竭的严重程度而降低.

Objective To explore the clinical application of severity diagnosis through determining blood lipid and TH levels in patients with heart failure of CHD.Methods Blood lipid（TC,TG,HDL-C and LDL-C）（with biochemistry method） and serum TH（T3,T4,FT3,FT4 and TSH）（with chemiluminescence immunoassay） levels were determined in 136 patients with heart failure of CHD（including classⅠ38 cases,class Ⅱ 33 cases,class Ⅲ 34 cases and class Ⅳ 31 cases）,36 patients with AMI and 60 normal controls.Results Serum TC,TG and LDL-C levels in patients with heart failure of CHD were significantly higher than those in controls（P all〈0.05）,and decreased with severity of heart failure,but serum HDL-C level was not significantly different from those in controls,and decreased with severity of heart failure also.The four indexes of blood lipid in patient with AMI were lowest in these patients（P all〈0.05）.In TH analysis,serum T3 and FT3 levels in patients with heart failure of CHD were significantly lower than those in controls（P all〈0.05）,and decreased with severity of heart failure.Serum T3 and FT3 levels in patients with AMI were lowest.Serum T4,FT4 and TSH levels in patients with heart failure of CHD and in patients with AMI were not significantly different from those in controls（P all〉0.05）.Conclusion There was abnormal metabolism in patients with heart failure of CHD.Serum TC,TG and LDL-C levels significantly increased,but serum T3 and FT3 levels significantly deceased,and they decreased with severity of heart failure.