胸外科术后心律失常患者血清甲状腺激素水平变化分析  

Analysis of the changes of serum throid hormones in post thoracic surgery patients

作　　者：王双林[1] 梁旭[2] 孙娟[2] 周慧[3] 张鹏[1] 

机构地区：[1]天津医科大学总医院心胸外科,300052 [2]天津医科大学基础医学院,300070 [3]天津市临床药物关键技术重点实验室,天津医科大学药学院,300070

出　　处：《国际生物医学工程杂志》2015年第6期365-368,共4页International Journal of Biomedical Engineering

摘　　要：目的研究并探讨胸外科术后患者发生心律失常与血清中各种甲状腺激素水平之间的关系。方法收集2012年9月至2015年2月天津医科大学总医院收治的44例胸外科术后患者资料，按心律失常诊断标准分为心律失常组和非心律失常组，进行回顾性分析。观察患者血清中各种甲状腺激素水平、心电图及生理健康等情况，比较两组患者血清中各种甲状腺激素水平的差异，并尝试探索这些患者血清中各种甲状腺激素水平和急性生理与慢性健康评分（APACHE II）之间的线性关系。结果术后心律失常组患者的血清三碘甲状腺原氨酸（T3）及游离三碘甲状腺原氨酸（FT3）水平均低于正常值；术后非心律失常组患者的血清T3及FT3水平基本处于正常范围内；两组患者的血清T3及FT3水平间差异均有统计学意义（P〈0．05）。血清中其他甲状腺激素水平变化差异均无统计学意义（P〉0．05），未发现患者血清甲状腺激素水平与其APACHE II评分显著相关。结论术后心律失常组与非心律失常组患者的血清T3及FT3水平存在显著差异，围术期甲状腺激素的替代治疗在临床防治心律失常及改善患者预后方面值得考虑和尝试。Objective To investigate the relationship between thyroid hormone levels and the attack of arrhythmia after thoracic surgery. Methods Information of 44 patients after thoracic surgery form September 2012 to February 2015 in General Hospital of Tianjin Medical University was collected, and divided in to the arrhythmia group and non-arrhythmia group. A retrospective analysis was carried on their ECG, thyroid hormone levels, and physical health, and the parameters were then compared between the two groups. The correlation of triiodothyronine （T3） level and Acute Physiology and Chronic Health Evaluation （APACHE II） was analyzed. Results The arrhymia patients＂ serum T3 and free tfiiodothyronine （FT3） levels were below normal levels, while the serum T3 and FT3 levels of the non-arrhythmia patients were within normal range, and the differences between the two groups were significant （P〈0.05）. No notable change of other thyroid hormones levels and correlation of T3, FT3 and APACHE II score were found. Conclusions There is a significant difference between the arrhythmia and non-arrhythmia groups in serum T3 and FT3 levels. Perioperative thyroid hormone replacement therapy is worthy of consideration and trial in the clinical prevention and treatment of arrhythmia and prognostic improvement of patients.

关 键 词：甲状腺激素 胸外科术后 心律失常 

分 类 号：R541.7[医药卫生—心血管疾病] R446.62[医药卫生—内科学]