肺心病患者血清甲状腺激素变化的意义

The Significancy of Change of Serum Thyroid Hormone Levels in Chronic Cor Pulmonal

测定了101例肺心病患者的血T_3、T_4水平。分析显示,T_3、T_4水平与心功能衰竭程度相关。将T_3降低的69例随机分为口服甲状腺片补充治疗组(33例)和一般处置对照组(36例)。试验开始一月内,治疗组死亡12例,对照组仅2例。差异极显著。认为肺心病中血清甲状腺激素的变化是疾病过程中被损伤的直接后果,而非代偿反应。补充甲状腺激素治疗是不适宜的。

The serum T3 and T4 levels were determined in 101 patients with chronic cor pulmonal. The cases who had low T3 level (<1.54nmol/L) were randomisally divided into the replacement therapy group (n=33) and the control group(n=36). Pretreatment clinical features and laboratory test results were similar in both groups. Expert the administration of thyroideum in the replacement group, the management was also similar in both groups The results showed:(1)the T3 was corelated with age and severety of heart failue (r=-0.30, r=-0.36 respectively:p<0.01),(2) T4 was also corelated with the severaty of heart failure (r=-0.29, p<0.01); and (3) within one month after admission 12 patients died in the replacement therapy group, but only 2 in the control group. We conclude that the change of serum thyroid hormone level in chronic cot pulmonal and other non-thyroudal illness (NTI)is one of directive consequences ef pathological insults, but rather than the compensation. And the replacement therapy is not indicated.