老年充血性心力衰竭患者血清甲状腺激素的变化

Changes of thyroid hormone in senile patients with congestive heart failure

目的 观察老年人充血性心力衰竭 (CHF)患者血清甲状腺激素 (TH)的改变 ,探讨TH与CHF病情和预后的关系。方法 观察组 ( 6 0例 )按NYNA心功能分级标准分类心力衰竭等级 ,用放射免疫法测定血清游离三碘甲状腺原氨酸 (FT3)、游离甲状腺素 (FT4 )、促甲状腺素 (TSH)各参数水平 ,并与对照组 ( 30例 )比较。结果 与对照组比较 ,FT3 明显降低 (P <0 .0 1) ,FT4 降低仅见于部分心功能Ⅳ级患者 ,而TSH无明显改变 ;心衰愈重FT3 降低愈明显 ,两者呈正相关。结论 老年人CHF患者存在继发性TH代谢异常 ,FT3 和 (或 )FT4 降低可作为CHF患者病情和预后判断的指标。

Objective To observe the changes of thyroid hormone in senile patients with congestive heart failure (CHF) and to investigate the correlation between prognosis of the disease and serum thyroid hormone.Methods The obs ervation group (n=60) were classified by heart NYHA failure class criteria,FT 3,FT 4 and TSH were measured by radioimmunoassay.The thirty healthy subjects served as control group.Results The FT 3 in observation group decreased significantly (P<0.01),as compared with that in control group.The reduction of FT 4 occured only in partial patients whose heart function was class Ⅳ,whereas their TSH was normal.The worse the degree of heart failure was,the more obvious the reduction of FT 4,both were positively correlated.Conclusion The secondary abnormal thyroid hormone metablism exists in senile patients with CHF,the low level of serum FT 3 and/or FT 4 might serve as the index by which to evaluate the state of the illness and prognosis in senile patients with CHF.