甲状腺激素与儿童先天性心脏病合并肺炎心力衰竭的相关性研究.docVIP

甲状腺激素与儿童先天性心脏病合并肺炎心力衰竭的相关性研究 　　[摘要] 目的 观察先天性心脏病合并肺炎心力衰竭患儿甲状腺激素水平变化，探讨不同心功能分级下甲状腺激素水平与心功能的相关性变化。 方法 选取2012～2014年我院儿科先天性心脏病合并肺炎心力衰竭住院患儿112例作为研究对象，将其设为先心合并肺炎心衰组，采用改良Ross标准评分法将其分为轻度心衰组、中度心衰组、重度心衰组，选取同期体检的健康正常儿童48例作为对照组，比较各组甲状腺激素水平及与心功能的相关性变化。 结果 先心合并肺炎心衰组T3、FT3、FT4水平降低，与对照组比较差异有统计学意义（P0.01）。随着心功能不全程度的加重，T3、FT3水平下降程度越明显，心功能不全的严重程度与T3呈负相关（r=-0.562）。 结论 动态观察先天性心脏病合并心衰患儿血清甲状腺激素变化，可作为疾病严重程度及预后的新客观指标，对改善心力衰竭的预后及生长发育、机体代谢平衡有重要的临床意义。 　　[关键词] 甲状腺激素；先天性心脏病合并肺炎心力衰竭；心功能 　　[中图分类号] R725.4 [文献标识码] A [文章编号] 1674-4721（2016）04（b）-0092-03 　　[Abstract] Objective To observe the changes of thyroid hormones in different levels in pediatric patients suffering from congenital heart disease（CHD） combined with cardiac failure due to pneumonia，and to probe into the correlations between thyroid hormones levels in different cardiac functional grading and cardiac function. Methods From 2012 to 2014，112 pediatric patients suffering from CHD with cardiac failure due to pneumonia in our department were selected as research objects and were set as congenital heart disease complicated with pneumonia and heart failure group.They were divided into mild，moderate，and severe cardiac failure groups based on modified Ross standard evaluation method.Forty-eight healthy children in the same period after physical examinations were classified into control group.The levels of thyroid hormones among groups and correlations between different levels of thyroid hormones and cardiac functions were compared. Results In CHD with cardiac failure due to pneumonia，there were changes in thyroid hormones levels，like decrease of T3，FT3，FT4，which were displayed statistical differences in the control group（P0.01）.With the severity of cardiac insufficiency，the decreases in T3 and FT3 were more significant.The severity of cardiac insufficiency was in a negative correlation between changes of T3（r=-0.562）. Conclusion Dynamic observation of serum thyroid hormones changes in children suffering from CHD with cardiac failure can b