摘要
目的：观察甲状腺激素在各级心功能期的变化和预后的关系。方法：１６０例心脏病患者按纽约心脏协会分级方法分成４组，测定空腹血清甲状腺激素，观察统计各级心功能组Ｔ３、Ｔ４、ＦＴ３、ｒＦ４、４Ｔ３、ＴＳＨ值的变化规律及ＮＴＩＳ在各级心功能组的发生率和死亡比例的关系。结果：血清 Ｔ３、Ｔ４、ＦＴ３随心功能减退而逐降低， ｒＴ３反之升高，各级心功能组间差别显著（ Ｐ＜ ０．０５），而ＦＴ４、ＴＳＨ各组间无明显改变（Ｐ＞０ ．０５），而ＦＴ４、ＴＳＨ各组间无明显改变（Ｐ＜０．０５）。心功能Ⅰ级、Ⅱ级两组中无１例发生ＮＴＩＳ，而Ⅲ级、Ⅳ级组发生率分别占６７％和８８％，Ｉ级、Ⅱ级组与Ⅲ级、Ⅳ级组ＮＩＴＳ发生率比较差别显著（Ｐ＜０．０５）。 ＮＴＩＳ组７８例死亡２０例，占２５．６％，非 ＮＴＩＳ组８２例死亡７例。占 ８．５％，两组病死例数比较有显著意义（Ｐ＜０．０１）。结论：血清甲状腺激素中Ｔ３、Ｔ４、ＦＴ３可随心功能减退而降低，ｒＴ３反之升高。甲状腺激素水平能反映心功能状况。
Objective: To explore the change of thyroid hormone in different grades cardiac function periods and to investigate the relationship between the change of thyroid hormone and prognosis. Methods: 160 patients with cardiac diseases according NYHA grade were divided into four groups, and tested fasting serum throid hormone, and analysed change regular of T3, FT3, T4, FT4, rT3, TSH in different grade cardiac function groups as well as the incidence of nonthyroidal illness syndrome (NTIS) in different grade cardiac function groups and relationship between NTIS and death proportion. Results: The serum T3, T4 , FT3 reduced gradually following decreasing of cardiac function, rT3 was just the opposite, they were significant difference in different cardiac function groups (P <0. 05), however FT4 TSH had not signifi cant difference among different groups (P <0. 05). NTLS did not happen in two groups of the cardiac function I, Ⅱ grades, but NTIS accounted for respective 67 % and 88 % in cardiac function Ⅲ ,Ⅳ grades groups, the rates of NTIS had significant difference between cardiac function Ⅰ, Ⅱ grades and Ⅲ, Ⅳ grades (P<0. 05). The death rate was 25. 6 % on NTIS group (20-78), and was 8.5 % on non - NTIS group (7/82), there was significant difference between mortality of two groups (P < 0. 01 ). Conclusion: The T3, T4, FT3 of serum throid hormone may reduce following decreasing of cardiac function, rT3 is exactly the reverse. The level of throid hormone can reflect the condition of cardiac function, NTIS is one of the index for pathogenetic condition dangerous and unfavourable prognosis with cardiac dysfunction patients.
出处
《中国临床医学》
2000年第3期302-303,共2页
Chinese Journal of Clinical Medicine
关键词
甲状腺激素
心脏病
心功能
相互关系
Cardiac function Thyroid Hormone Nonthyroidal illness sysdrome
