初诊Graves病患者治疗前后血清氨基末端脑钠肽前体的水平变化

Change of NT-proBNP concentration before and after treatment in patients with newly-diagnosed Graves disease

目的通过观察初诊弥漫性甲状腺肿伴甲状腺功能亢进症(GD)患者治疗前后血清氨基末端脑钠肽前体(NT-proBNP)水平的前后变化,探讨甲状腺功能、静息心率与血清NT-proBNP水平的相关性。方法入选67例不伴有明显心功能不全的初诊GD患者,测定其治疗前及治疗后恢复至正常甲状腺功能状态时的NT-proBNP水平,同时测定20例甲状腺功能正常健康志愿者的NT-proBNP作为对照。结果初诊GD患者治疗前的NT-proBNP浓度较对照组高(P<0.05),经治疗达到正常甲状腺功能状态后,与对照组比较差异无统计学意义(P>0.05);NT-proBNP较治疗前下降,NT-proBNP的降低与游离三碘甲腺原氨酸(FT3)、游离甲状腺素(FT4)的降低呈正相关(P<0.05),与促甲状腺激素(TSH)、静息心率(RHR)的变化值无相关。结论血清NT-proBNP浓度受甲状腺功能状态的影响,甲状腺功能亢进状态可导致NTproBNP假性升高。

Objective To observe the change of serum N-terminal pro-brain natriuretic peptide(NT-proBNP)concentration before and after treatment in patients with newly-diagnosed Graves disease(GD)complicated with hyperthyroidism and to explore the relationships of thyroid function and resting heart rate(RHR)with NT-proBNP concentration.Methods Sixty-seven newly-diagnosed GD patients without cardiac dysfunction were enrolled.Serum concentration of NT-proBNP was measured before treatment and when thyroid function returned to normal after treatment,while NT-proBNP concentration of 20 health persons with euthyroidism was measured as normal control.Results NT-proBNP concentration in the GD patients was higher than that in the normal controls before treatment(P<0.05).When euthyroidism was achieved after treatment,NT-proBNP in the GD patients decreased and there was no difference between the GD patients and the normal controls(P>0.05).The decrease in NT-proBNP was positively correlated with the decrease in FT3 and FT4(P<0.05),but not correlated with the change in TSH level or RHR.Conclusions The concentration of NT-proBNP is affected by the status of thyroid function,hyperthyroidism may cause high NT-proBNP measurement.