神经肽Y及心肌肌钙蛋白T在甲状腺功能亢进性心脏病中的意义

Diagnostic Significance of Cardial Troponin T and Neuro peptide Y in Hyperthyroic Heart Disease

目的 探讨神经肽Y(NTY)心肌肌钙蛋白T(cTnT)在甲状腺功能亢进 (甲亢 )性心脏病诊断中的意义。方法 对我院 1998年 1月至 1999年 1月诊治的甲亢 2 3例 ,分别在治疗前、后进行NTY ,cTnT ,游离T3 ,游离T4 (FT3 ,FT4 ) ,促甲状腺素 (TSH)以及检测代表左心射血功能的指标心脏指数 (CI)和射血分数 (EF) ,并进行相关性对比。结果 NTY治疗前升高 192 .8± 7.1ng/L ,治疗后降至正常 ,t=2 .185 ,P <0 .0 5 ,差异有显著性。cTnT治疗前仅 6例升高 0 .13± 0 .0 4ng/L ,治疗后均降至正常 ,t =2 .0 8,P <0 .0 5 ,差异有显著性。治疗前EF有9/ 2 3例减低 ,治疗 4周后 8/ 13例恢复正常。NTY与CI,EF均成反比 ,其相关系数分别为 - 0 .333,- 0 .2 0 3。结论NTY ,cTnT在甲亢心脏病中均升高 ,NTY对心脏有负性肌力作用。甲亢性心脏病存在神经内分泌调节引起的继发性缺血性改变 ,只要治疗及时可以痊愈。

Objective To study the value of cardial troponin T (cTnT) and neuro peptide Y (NTY) in hyperthyroic heart disease. Methods The concentrations of serum cTnT and NTY were measured by ELISA method in 23 patients with hyperthyroidism, and were correlated with the myocardial systolic functions (cardic index, CI; ejective fration, EF) before and after the treatment. Results The concentrations of cTnT, NTY, FT 3, FT 4 and blood pressure (BP) at the beginning were 0.13 ± 0.04 ng/L, 192.8 ± 7.1 ng/L, 36.79 ± 4.94 ng/L, 52.96 ± 16.18 ng/L and 123.69 ± 10.06 mmHg, which after the treatment were 0.06 ± 0.03 ng/L, 140.2 ± 5.1 ng/L, 11.52 ± 4.74 ng/L, 26.81 ± 5.18 ng/L and 105.00 ± 8.66 mmHg while TSH was lower at the beginning ( 1.21 ± 0.45 U/L) than after the treatment ( 1.84 ± 0.29 U/L) in hyperthyroidism (t= 2.185 , 2.08 , 13.3 , 4.53 and 4.84 , respectively). The myocardial systolic functions were damaged in hyperthyroidism. The interrelations between NTY and CI, EF were negative in hyperthyroidism (r= -0.333 and -0.203 , Y= 276.21 - 21.785 X; Y= 0.632 - 2.902 X, respectively). Conclusions The concentrations of NTY and cTnT are higher in hyperthyroic heart disease. The higher the NTY and cTnT concentrations, the worse the myocardial systolic functions.