心脏围手术期血甲状腺激素的变化对术后病情和预后的影响

目的：观察心脏围手术期甲状腺激素的变化，研究其对心脏术后病情及预后的影响。方法：２１例心脏手术患者手术前后各时间占取静脉血标本，用放射免疫法测定甲状腺激素含量，并观察术后患者病情变化及预后。结果：体外循环（ＣＰＢ）期间以及术后Ｔ３、Ｔ４、ＦＴ３均明显降低，Ｔ３、Ｔ４在转流至最低体温时达到最低，术后５ｄ仍明显低于术前水平。ｒＴ３在ＣＰＢ期间稍下降，术后即迅速上升，２ｄ后达到高峰。分组研究表明，术后病

Change of perioperative serum thyroid hormone during heart surgery and its effect on postoperative illness and prognosis

Objective:To observe the changes of perioperative serum thyroid hormone and its effects on postoperative illness and prognosis. Metbods:Blood samples were obtained from 21 patients before,during,and after heart operations.Thyroid hormones were measured by radio immunoassay and the patients'postoperative illness and prognosis were observed. Results:Serum T3,T4 and FT3 levels significantly declined during cardiopulmonary bypass(CPB) and thereafter.Serum T3 and T4 concentrations reached their nadir at the lowest hypothermia of CPB. rT3 declined during CPB, rose immediately after operation and reached its summit at the 2nd day postoperatively. Most patients, whose serum concentrations of T3 and T4 increased after operation , had uneventful recoveries.A part of patients,whose concentrations of T3 and T4 maintained lower levels postoperatively, had complications or deaths.Conclusion: CPB may produce low T3 syndrome.The change of thyroid hormone may have an effect on postoperative illness and prognosis,and may be an important index to evaluate them.