慢性心力衰竭患者血甲状腺素水平与心功能的关系研究

Relationship between peripheral blood thyroxine levels and cardiac function in patients with chronic heart failure

目的探讨老年慢性心力衰竭患者外周血甲状腺素水平与心功能的关系。方法选取2016年1月至2017年12月我院收治的70例慢性心力衰竭患者作为研究组,同时选取70例健康者作为对照组,两组患者均测定左心室射血分数(LVEF)和血清甲状腺素水平。结果患者LVEF、血清总三碘甲状腺原氨酸(TT3)、血清总甲状腺素(TT4)研究组低于对照组[(37.3±2.4)%与(58.5±5.3)%、(87.4±8.7)mmol/L与(120.8±10.4)mmol/L和(8.6±1.7)mmol/L与(10.1±1.3)mmol/L,t=30.486、20.609和5.864,均P=0.000];Ⅱ级、Ⅲ级和Ⅳ级心功能不全患者,LVEF、TT3和TT4分别为[(42.3±2.2)%、(37.9±1.0)%和(31.8±1.5)%,(104.2±15.4)mmol/L、(89.7±4.6)mmol/L和(72.0±7.2)mmol/L,(9.3±1.8)mmol/L、(8.8±1.3)mmol/L和(8.1±0.9)mmol/L],慢性心力衰竭患者随着其心功能不全不断加重,血清TT3、TT4和LVEF水平不断降低(均P=0.000)。结论慢性心功能不全患者多伴随正常甲状腺病态综合征,其血清内TT3和TT4水平能提示心脏收缩功能异常程度,因此血清低T3和T4可作为慢性心力衰竭患者预后不良指标。

Objective To investigate the relationship between peripheral blood thyroxine levels and cardiac function in elderly patients with chronic heart failure. Methods Seventy patients with chronic heart failure admitted into our hospital from January 2016 to December 2017 were enrolled as the study group, and 70 healthy subjects were collected as the control group. Left ventricular ejection fraction(LVEF)and serum thyroxine levels were measured in both groups. Results LVEF, serum levels of total triiodothyronine(TT3)and total thyroxine(TT4)were lower in the study group than in the control group[(37.3±2.4)% vs.(58.5±5.3)%,(87.4±8.7)mmol/L vs.(120.8±10.4)mmol/L,(8.6±1.7)mmol/L vs.(10.1±1.3)mmol/L, t=30.486, 20.609 and 5.864, P=0.000]. LVEF, TT3 and TT4 in patients with grade Ⅱ、grade Ⅲ and grade ⅣCardiac insufficiency were[(42.3±2.2)%、(37.9±1.0)% and(31.8±1.5)%,(104.2±15.4)mmol/L、(89.7±4.6)mmol/L and(72.0±7.2)mmol/L,(9.3±1.8)mmol/L、(8.8±1.3)mmol/L and(8.1±0.9)mmol/L]respectively. Serum levels of TT3 and TT4 and LVEF steadily declined as cardiac dysfunction grew more severe in patients with chronic heart failure(P=0.000). Conclusions Patients with chronic cardiac insufficiency are often combined with euthyroid sick syndrome, and serum levels of TT3 and TT4 can indicate the degree of abnormal cardiac systolic function. Therefore, low serum levels of T3 and T4 can be used as indicators for poor prognosis in patients with chronic heart failure.