慢性心力衰竭患者的甲状腺激素水平变化  

Serum thyroid hormone levels in the patients with chronic heart failure

作　　者：赵培[1] 李伟[1] 刘萍[1] 陈明星[1] 龚开政[1] 

机构地区：[1]扬州市第一人民医院心血管内科,江苏省扬州市225001

出　　处：《实用老年医学》2015年第5期396-398,共3页Practical Geriatrics

摘　　要：目的观察慢性心力衰竭(CHF)患者中正常甲状腺功能病态综合征(SES)的发生率,及其与脑钠肽(BNP)和心功能的关系。方法入选CHF患者96例[美国纽约心脏病学会(NYHA)分级Ⅱ级19例,Ⅲ级36例,Ⅳ级41例],对照组(NYHA分级I级)29例。测定血清甲状腺激素水平,超声心电图检测左室射血分数(LVEF)和左室舒张末直径(LVEDD),采用干式快速定量心衰心梗诊断仪通过免疫荧光法测定CHF患者血清BNP水平。结果 CHF患者SES发生率为30.2%,随着心功能分级增加,SES发生率依次升高;CHF合并SES患者BNP明显升高、LVEDD扩大、LVEF下降。结论 CHF患者高发SES,结合血浆BNP及LVEF测定有助于全面评估心衰严重程度及预后。Objective To investigate the incidence of sick euthyroid syndrome（SES） in the patients with chronic heart failure（ CHF） and the relationship between brain natriuretic peptide（ BNP） and cardiac function. Methods A total of 125 patients were enrolled in this study,with 19 cases of NYHA class Ⅱ,36 cases of NYHA class Ⅲ,41 cases of NYHA class Ⅳ,and 29 cases of NYHA class Ⅰ. The serum levels of total tetrai odothyronine（ T3）,free tetrai odothyronine（ FT3）,total thyroxine（ T4）,free thyroxine（ FT4） and thyroid stimulating hormone（ TSH） in all patients were measured. The left ventricular ejection fraction（ LVEF） and left ventricular end diastolic dimension（ LVEDD） were determined by echocardiography. The serum levels of BNP in CHF patients were detected with dry fast quantitative myocardial infarction heart failure diagnostic apparatus by immunofluorescence. Results SES was diagnosed in 29 patients（30. 2%）. The incidence of SES significantly increased with the increase of the NYHA classification. The levels of BNP and LVEDD were higher and the level of LVEF was lower in CHF patients with SES than those in patients without SES.Conclusions CHF patients tend to suffer from SES. The combination measurement of BNP and LVEF might help to comprehensively evaluate the degree of functional cardiac impairment and prognosis.

关 键 词：心力衰竭 充血性 甲状腺激素 

分 类 号：R541.6[医药卫生—心血管疾病] R581[医药卫生—内科学]