甲状腺激素在心血管疾病诊断和治疗中的临床应用

目的 探讨甲状腺激素在心血管疾病诊断和治疗中的临床应用.方法 用发光免疫分析法150例冠心病心力衰竭患者,86例急性心肌梗死(AMI)患者,103例肺心病患者和47名我院健康体检者(正常对照组)血清中的甲状腺激素水平.结果 冠心病心力衰竭患者、AMI患者和肺心病患者血清中三碘甲腺原氨酸(T3)、游离三碘甲腺原氨酸(FT3)及T3/反转三碘甲腺原氨酸(rT3)较正常对照组明显降低(t=2.120、2.214、4.356,P均＜0.05),而血清rT3明显增高(t=2.256、4.416、4.512,P均＜0.05).冠心病心力衰竭患者的血清T3、FT3及T3/rT3随心力衰竭的严重程度明显降低;肺心病急发期较缓解期降低明显,rT3则增加明显.冠心病心力衰竭患者、AMI患者和肺心病患者血清中甲状腺素、游离甲状腺素和促甲状腺激素与正常对照组比较无明显差异(t=1.781、1.813、1.754,P均＞0.05).结论 血清T3、FT3和T3/rT3的降低和rT3的增高是诊断冠心病心力衰竭及严重程度、AMI和肺心病急发期或缓解期的有效指标,并具有治疗后随访的临床价值.

Clinical application of thyroid hormone in diagnosis and therapy on cardiovascular disease

Objective To study clinical application of sera thyroid hormone in diagnosis and therapy on cornary heart disease(CHD)heart failure, acute myocardial infarction(AMI) and pulmonary heart disease.Methods Determined the changes of serum triiodothyronine(T3), tetraiodothyronine(T4), free triiodothyronine (FT3), free tetraiodothyronine(FT4), thyroidstimulating hormone(TSH ), reverse triiodothyronine (rT3) and T3 /rT3 levels in 150 cases patients with CHD heart failure, 86 cases patients with AMI, 103 cases patients with pulmonary heart disease and 47 cases normal controls by chemiluminescent measurement. Results The serum levels of T3, T4, FT3, FT4, TSH, rT3 and T3 / rT3 in CHD heart failure, AMI pulmonary heart disease were compared with normal controls. Serum T4, FT4 and TSH levels were not different between above patients and normal controls(t=2.120, 2.214, 4.356, P＜0.05), but the serum T3, FFT3 and T3/rT3 were significantly decreased than those of normal controls(t=2.256, 4.416, 4.512, P＜0.05). The serum rT3 levels were significantly increased those of than normal controls (t=1.781, 1.813, 1.754, P＞0.05). The serum T3, FT3 and T3 /rT3 levels were significantly decreased in patient with CHD heart failure severity. But the serum rT3 levels was significantly increased. Conclusion The present study showed that change of serum T3, FT3 and T3 / rT3 levels in patients with CHD heart failure, AMI and pulmonary heart disease were inpartant marker and could reflect the severity of disease and used as diagnostic or treatment indicators.