老年人充血性心力衰竭的甲状腺激素变化

Plasma thyroid hormone changes in aged patients with congestive heart failure

目的 旨在探讨老年人充血性心力衰竭 (ACHF)的甲状腺功能变化。方法 本实验收集了 6 0例ACHF病例 ,正常老年人 30例。分治疗前 ,治疗后及正常组 3组对照。分别测定血浆三碘甲状腺原氨酸 (T3 ) ,甲状腺素 (T4 ) ,游离三碘甲状腺原氨酸 (FT3 ) ,游离甲状腺素 (FT4 ) ,促甲状腺素 (TSH)。结果 老年CHF治疗前血浆T3 ,FT3 低于治疗后 (P <0 .0 1) ,显著低于正常对照组 (P <0 .0 1) ,老年ACHF治疗前血浆T4 ,FT4 明显低于治疗后 (P <0 .0 5 )及正常组 (P <0 .0 5 ) ,老年CHF治疗前TSH低于治疗后及正常组 (P <0 .0 5 )。老年CHF治疗后T3 ,FT3 ,TSH低于正常对照组 (P <0 .0 5 ) ,而T4 ,FT4 不显示明显相关性 (P >0 .0 5 )。结果还显示血浆T3 ,FT3 ,T4 ,FT4 ,TSH下降与心衰程度呈正相关。结论 老年CHF患者体内T3 ,FT3 明显降低 ,提示CHF老年患者如何应用T3 治疗值得进一步研究。

Objective To study the thyroid hormone changes in aged patients with congestive heart failure (CHF). Method 60 aged patients with CHF and 30 healthy aged individuals as treated and control groups were enrolled. T 3, FT 3, T 4, FT 4, and TSH were determined by radioimmunoassay. Results The levels of T 3, FT 3 in aged CHF group before treatment were lower than those after treatment and significanty lower than those of healthy aged individuals group ( P <0.01), the levels of T 4, FT 4 TSH showed similar findings ( P <0.05). The levels of T 3, FT 3, TSH in those after the treatment were also lower than the healthy aged individuals group ( P <0.05) and there were no significant differences in T 4, FT 4 between the two groups ( P >0.05). Furthermore, the levels of the T 3, FT 3, F 4, FT 4, TSH showed positive correlationship with the degree of CHF in the aged. Conclusion the levels of T 3, FT 3 in the CHF aged patients decreased, whether therapy with T 3 can be used in these patients worths further investigation. (Shanghai Med J, 2000,23∶680 681)