不同表现甲状腺功能亢进症心脏病患者内皮素和肿瘤坏死因子α的变化  

Changes of endothelin and tumor necrosis factor-alpha in patients of hyperthyroidism heart disease with different clinical manifestations

作　　者：郭雅卿[1] 吴颂红[1] 赵丹宁[1] 崔克勤[1] 胡玲[1] 

机构地区：[1]河北大学附属医院内分泌科,河北保定071000

出　　处：《临床荟萃》2007年第22期1617-1619,共3页Clinical Focus

摘　　要：目的观察不同临床表现甲状腺功能亢进症心脏病(简称甲亢心)患者血内皮素(ET)和肿瘤坏死因子α(TNF-α)的变化,探讨ET和TNF-α与甲亢性心脏病临床表现的关系。方法分别测定30例单纯甲亢及150例甲亢心患者(按不同临床表现又分为心律失常、心绞痛及心力衰竭等亚组)血游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、ET、TNF-α,与30例正常对照组比较。结果①单纯甲亢及甲亢心组患者血FT3、FT4、ET、TNF-α与对照组比较均显著增高(P<0.01),促甲状腺激素(TSH)显著降低(P<0.01);甲亢心组患者血FT3、ET、TNF-α与单纯甲亢组比较显著增高(P<0.01)。②心律失常、心绞痛及心功能Ⅰ/Ⅱ级亚组甲亢心患者血TNF-α比较无统计学意义(P>0.05),此后,随着心功能损伤级别增高,TNF-α逐渐增高(P<0.01)。结论ET、TNF-α与甲亢性心脏病心功能状态密切相关,应用ET、TNF-α受体拮抗剂有可能延缓甲亢心脏病心力衰竭的进展。Objective To study the changes of serum endothelin and tumor necrosis faetor-alpha（TNF-α） in the patients of hyperthyroidism heart disease with different clinical manifestations and to discuss their effect on clinical manifestations of hyperthyroidism heart disease. Methods The levels of serum free tri-iodothyronine（FT3） ,thyroxine （FT4） ,endothelin and TNF-α in 30 eases of hyperthyroidism,150 eases of hyperthyroidism heart disease and 30 normal controls were determined. Results ① The serum levels of FT3, FT4,endothelin and TNF-α of hyperthyroidism and hyperthyroidism heart disease group were significantly higher than those of control group （ P〈0.01） ; while the level of thyrotropie hormone was significantly lower （P 〈 0.01）. The serum levels of FT3, endothelin and TNF-α of hyperthyroidism heart disease group were significantly higher than those of hyperthyroidism group （ P 〈0.01）. ② There were no significant differences in the serum levels of endothelin and TNF-α between three groups with hyperthyroidism heart disease （arrhythmia group,angina peetoris group and NYHA Ⅰ/Ⅱ group） （P 〉.05）; but they were elevated according with the worsening of heart failure（NYHA classification） （ P〈0.01）. Conclusion Close relationship between cardiac function of hyperthyroidism and levels of serum endothelin and TNF-α exists, the antagonist of endothelin and TNF-α could delay the progression of hyperthyroidism heart failure.

关 键 词：甲状腺功能亢进症 心脏病 膜蛋白质类 肿瘤坏死因子Α 

分 类 号：R541.86[医药卫生—心血管疾病]