心力衰竭患者血清甲状腺激素水平变化及临床意义

Change of the level of serum thyroid hormone in patients with chronic heart failure and its clinical significances

目的探讨心力衰竭患者血清甲状腺激素水平的变化及其临床意义。方法选择2016年2~12月深圳市光明新区人民医院收治的60例心力衰竭患者作为观察组,选择同期因心绞痛、心律失常等住院治疗的55例患者作为对照组,检测各组甲状腺激素水平,比较两组患者之间以及心力衰竭不同心功能分级患者之间三碘原氨酸(T3)、甲状腺素(T4)、游离三碘原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺激素(TSH)水平的差异。结果观察组患者的T3、T4、FT3、FT4水平分别为(1.57±0.23)μg/L、(98.09±20.46)μg/L、(4.32±0.75)pmol/L、(15.28±0.26)pmol/L,均明显低于对照组的(2.42±0.24)μg/L、(113.3±20.43)μg/L、(6.83±0.77)pmol/L、(20.36±0.28)pmol/L,TSH水平为(16.61±1.57)U/L,明显高于对照组的(6.72±1.58)U/L,差异均有统计学意义(P<0.05);观察组患者随心功能分级的升高,T3、T4、FT3、FT4水平降低,TSH浓度升高,各组间比较差异均具统计学意义(P<0.05)。结论心力衰竭患者存在甲状腺激素代谢紊乱现象,监测甲状腺激素水平变化有利于合理应用药物治疗,改善预后。

Objective To discuss the change of serum thyroid hormone in patients with CHF and its clinical significances. Methods A total of 60 patients with CHF, who admitted to the People＇s Hospital of Guangming New District of Shenzhen during February 2016 to December 2016 were selected as the observation group, and 55 patients with angina pectoris or arrhythmia were enrolled into the control group. The level of serum thyroid hormone were mea-sured, and the levels of triiodothyronine （T3）, thyroxine （T4）, free T3 （FT3）, free T4 （FT4）, thyrotropin （TSH） in the two groups and heart failure patients with different cardiac function classification were compared. Results The levels of T3, T4, FT3, FT4 in the observation group were （1.57±0.23）μg/L, （98.09±20.46）μg/L, （4.32±0.75） pmol/L, （15.28± 0.26） pmol/L, respectively, which were significantly lower than the corresponding （2.42±0.24）μg/L, （113.3±20.43）μg/L, （6.83±0.77） pmol/L, （20.36±0.28） pmol/L in the control group （P〈0.05）;the level of TSH in the observation group was （16.61±1.57） U/L, which was significantly higher than （6.72±1.58） U/L in the control group （P〈0.05）. With the increas-ing of the cardiac function classification, the levels of T3, T4, FT3, FT4 were significantly decreased, and TSH signifi-cantly increased in the observation group （P〈0.05）. Conclusion Thyroid hormone metabolism disorder exists in pa-tients with heart failure. Monitoring the changes of thyroid hormone levels is conducive to the rational use of drug treat-ment and the improvement of the prognosis.