慢性肺原性心脏病甲状腺功能的临床观察

CLINICAL STUDY ON THYROID FUNCTION IN PATIENTS WITH COR PULMONALE

采用放射免疫法测定３９ 例肺心病病人治疗前后血清甲状腺激素水平，结果显示：肺心病急性发作期血清ＴＴ３、ＦＴ３、ＦＴ４ 均明显低于正常人（Ｐ＜ ０．０１），治疗缓解期明显回升。肺心病人急性发作期血清ＦＴ３、ＴＴ３ 降低与ＰａＯ２ 水平呈显著正相关（Ｐ＜ ０．０５）。提示肺心病低Ｔ３、Ｔ４ 发生机理可能与缺氧影响Ｔ４ 向Ｔ３ 转化及抑制下丘脑－ 垂体－ 甲状腺轴，使ＴＳＨ 分泌相对减少有关。

RIA was carried out to determine the level of TT 3, TT 4, FT 3, and FT 4 in 39 patients with cor pulmanale. The results showed that the serum level of TT 3, FT 3 AND FT 4 in the acute stage of patients with heart disease was significantly lower than that in normal persons(P<0.01) but were tremendously increased during the treatment. On the other hand, the decrease of the serum level of FT 3 and TT 3 in patients with cor pulmonale showed a remarkable positive correlation with PaO 2 (P<0.05). It is suggested that the decreased serum level of both T 3 and T 4 in patients with cor pulmonale may be the result of the disturbance of the transformation of T 4 into T 3 by anoxia and hyposecretion of TSH, which,in fact, is a physiological adaptive reaction of the body.