天津医药

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心力衰竭患者甲状腺激素和B型钠尿肽水平与心功能的关系

魏锦1,李彤2,段大为2   

  1. 1. 天津市第三中心医院（寄家里）
    2. 天津市第三中心医院
  • 收稿日期:2010-06-11 修回日期:2010-07-25 出版日期:2011-06-15 发布日期:2011-06-15
  • 通讯作者: 魏锦

The relationship between the cardiac function and the level of thyroid hormone, B-type natriuretic peptide(BNP) in the congestive heart failure patients

  • Received:2010-06-11 Revised:2010-07-25 Published:2011-06-15 Online:2011-06-15

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摘要： 目的：探讨患者体内甲状腺激素水平、B型钠尿肽(BNP)、左室射血分数（LVEF）与心功能分级之间的关系。方法：将150例患者依据纽约心脏病协会(NYHA)心功能分级分为：Ⅰ级（即对照组），Ⅱ级, Ⅲ级及Ⅳ级4组，并将Ⅱ级, Ⅲ级及Ⅳ级三个组统称为慢性充血性心力衰竭组（CHF组），测定150例患者血清中游离甲状腺原氨酸（FT3）、游离甲状腺素（FT4）、总三碘甲状腺原氨酸（TT3）、总四碘甲状腺原氨酸（TT4）、血清促甲状腺素（TSH）水平及BNP浓度，并作超声心动图检查测定LVEF，观察患者血清中甲状腺激素水平、BNP水平及LVEF水平与心功能的关系。结果：慢性充血性心力衰竭患者FT3、TT3水平及LVEF低于对照组，且差别有统计学意义(P＜0.05), 血清BNP水平高于对照组，且差别有统计学意义(P＜0.05)；150例患者按照不同心功能分级FT3、TT3水平、BNP水平及LVEF四个组均存在差异，且差别有统计学意义（P<0.05）。结论：动态监测甲状腺激素及BNP水平的变化可作为判断心力衰竭严重程度的指标。

关键词: 充血性心力衰竭, 甲状腺激素, B型钠尿肽

Abstract: Objective： To analysis the relationship between the cardiac functional grading and the level of thyroid hormone, B-type natriuretic peptide(BNP),Left ventricular ejection fraction(LVEF).Methods:The 150 patients have been divided into 4 groups,the chronic congestive heart failure(CHF) group and the control group.All the patients have been measured the levels of free triiodothyronine (FT3),total triiodothyronine(TT3),free thyroxine (FT4), total thyroxine（TT4）, thyroid-stimulating hormone(TSH) and BNP in the plasma by the radioimmunoassay and the immunofluorescence method.Meanwhile to monitor the LVEF by Echocardiography.Result: The level of the FT3、TT3 and LVEF are lower in the CHF group than in the control group with significant difference,while the BNP level are higher in the CHF group with significant difference; According to the cardiac functional grading,there are significant difference in the FT3、TT3,BNP and LVEF in patients. Conclusion: The level of the thyroid hormones,LVEF and BNP can be the indicators to evaluate the extent of CHF.

Key words: congestive heart failure, thyroid hormone, brain natriuretic peptide