心力衰竭和低T3综合症相关性.docVIP

心力衰竭与低T3综合症的相关性 作者： HYPERLINK /Article/xunh/200506/Article_3715.html \l # \o 王旭东 王旭东????文章来源：世界急危重病医学杂志????点击数： 197????更新时间：2005-6-22 【摘要】目的探讨急性心力衰竭和慢性心力衰竭 游离三碘 甲状腺原氨酸（FT3）水平的关系。方法观察测定46例急性心力衰竭和 75例慢性心力衰竭患者的FT3、FT4和TSH水平， 与健康对照组比较。结果发现急性心力衰竭与慢性心力衰竭患者的FT3 水平 均降低，按照纽约心脏病学会（NYHA）分类方法，心功能IV级组2.09±0.61 pmol/L 、II I级组2.12±0.51 pmol/L、II级2.35±0.66 pmol/L和健康对照组3.90±0.83 pmol/L （P=0.001）。FT3水平与血压，心率没有明显相关性。结论 FT 3水平与心力衰竭的发作严重程度相关，与心力衰竭的病程无相关性。 【关键词】心力衰竭;? 低T3综合征 Correlation of Heart failure and euthyroid sick syndrome?? WANG XudongFU Yan Department of Emergency, Capital university of medical science affiliated? Beijing Tongren Hospital 100730 【Abstract】 Objective? To investigate the alteration of s erum free triiodothyronine (FT3) level in patients with acute heart failure and? chronic heart failure. Methods? FT3, FT4 and TSH from 46 p atients with acute heart failure and 75 patients with chronic heart failure were? measured by radioimmunology assay. Levels of FT3, FT4 and TSH were compare d with those in control subjects. Results The? levels of FT3 in both acute heart failure and chronic heart failure patients? were lower than that in control subjects. Subgroups of New York Heart Associati on functional class Ⅱ-Ⅳ heart failure were classified with class Ⅳ 2.09±0. 61 pmol/L, class Ⅲ 2.12±0.51 pmol/L, class Ⅱ 2.35±0.66 pmol/L and contro l 3.90±0.83 pmol/L respectively (P=0.001). It was found that Level of F T3 was not significantly associated wit pressure and heart rate. Conc lusion? Level of FT3 was associated with severity but not stages of he art failure. 【Key words】heart failure;? euthyroid sick syndrome?  　　心力衰竭为各种心脏疾患发展至晚期的临床综合症同时伴随体内多种神经内分泌变化，近年来人们认识到，部分急性心肌梗死、慢性心力衰竭、心脏移植术后患者存在血浆T 3的水平减低，而血浆T4和TSH水平正常，而将其称为低T3综合症［1,2］或非甲状腺病态综合症 （Nonthyroidal illness syndrome）［3］。本文对4年来我院急诊科收治的急性心力衰竭与慢性心力衰竭急性加重期患者甲状腺激素的变化进行比较分析，并探讨不同病程时期与低T3综合症的关系。 1资料和方法 1.1研究病例入选者为1998－2002年间我院急诊科就诊的心力衰竭 患者。急性心力衰竭包括了各种原因引起的左心功能不全，第一次发作的患者46例，平均年龄69.94±9.43岁 ， 其中急性心肌梗死26例，高血压病18例，心肌病2例。慢性心功能