CAJ | 학술논문

目的探讨充血性心力衰竭(CHF)患者甲状腺激素变化和心功能的关系。方法用放射免疫法测定36例CHF患者（CHF组）和同期健康体检者23例（正常对照组）血清三碘甲状腺原氨酸(T3)、四碘甲状腺原氨酸(T4)、反三碘甲状腺原氨酸(rT3)及促甲状腺素，用超声心动图测定心排血量(CO)、左心室射血分数(LVEF)、左心室舒张末容积(LVEDV)和左心室收缩末容积(LVESV)。结果 CHF组心功能Ⅲ、Ⅳ级患者（分别为16、10例）T3水平和LVEF、CO明显低于正常对照组[T3：(1.6±0.2) nmol/L、(1.5±0.2)nmol/L 比(2.0±0.3) nmol/L,LVEF:(54.4±8.3)％、(51.3±11.1)％比(59.0±8.9)％,CO:(4.3±2.6) L/min、(4.1±2.6) L/min比(5.5±1.6) L/min，P＜0.05或P＜0.01]，rT3和LVEDV、LVESV明显高于正常对照组[rT3:(0.6±0.3)nmol/L、(0.6±0.4)nmol/L比(0.3 ±0.1)nmol/L,LVEDV:(202±46)ml、(234±65)ml比(175±53) ml，LVESV：( 149±57) ml、(160±59)ml比(124±56)ml，P＜0.01]，且随着心力衰竭程度加重，其变化越明显。结论甲状腺激素变化对CHF患者心功能损害程度、治疗及预后具有重要意义。
목적 탐토충혈성심력쇠갈(CHF)환자갑상선격소변화화심공능적관계。방법 용방사면역법측정36례CHF환자（CHF조）화동기건강체검자23례（정상대조조）혈청삼전갑상선원안산(T3)、사전갑상선원안산(T4)、반삼전갑상선원안산(rT3)급촉갑상선소，용초성심동도측정심배혈량(CO)、좌심실사혈분수(LVEF)、좌심실서장말용적(LVEDV)화좌심실수축말용적(LVESV)。결과 CHF조심공능Ⅲ、Ⅳ급환자（분별위16、10례）T3수평화LVEF、CO명현저우정상대조조[T3：(1.6±0.2) nmol/L、(1.5±0.2)nmol/L 비(2.0±0.3) nmol/L,LVEF:(54.4±8.3)％、(51.3±11.1)％비(59.0±8.9)％,CO:(4.3±2.6) L/min、(4.1±2.6) L/min비(5.5±1.6) L/min，P＜0.05혹P＜0.01]，rT3화LVEDV、LVESV명현고우정상대조조[rT3:(0.6±0.3)nmol/L、(0.6±0.4)nmol/L비(0.3 ±0.1)nmol/L,LVEDV:(202±46)ml、(234±65)ml비(175±53) ml，LVESV：( 149±57) ml、(160±59)ml비(124±56)ml，P＜0.01]，차수착심력쇠갈정도가중，기변화월명현。결론 갑상선격소변화대CHF환자심공능손해정도、치료급예후구유중요의의。
Objective To explore the relationship between thyroid hormone (TH) changes and cardiac function in patients with congestive heart failure (CHF). Methods In CHF group (36 patients with CHF) and control group (23 non-CHF patients), three plasma triiodothyronine ( T3 ), four-triiodothyronine ( T4 ), thyroid iodine against three the original acid ( rT3 ) and thyroid stimulating hormone (TSH) were determined by radioimmunoassay ; cardiac output ( CO), left ventricular ejection fraction ( LVEF), left ventricular end diastolic volume ( LVEDV), left ventricular end systolic volume (LVESV) by echocardiography. Results In CHF group T3 levels and LVEF,CO were significantly lower than the control group[T3 : ( 1.6 ±0.2) nmol/L, ( 1.5 ±0.2)nmol/L vs (2.0 ±0.3)nmol/L,LVEF:(54.4±8.3)％,(51.3±11.1)％ vs (59.0±8.9)％,CO:(4.3 ±2.6)L/min,(4.1±2.6)L/min vs (5.5 ±1.6)L/min,P＜0.05 or P＜0. 01]; rT3, LVEDV and LVESV increased significantly[rT3 :(0.6 ± 0.3 ) nmoL/L, (0.6 ± 0.4) nmol/L vs (0.3 ± 0.1 ) nmol/L, LVEDV : (202 ± 46) ml, ( 234 ± 65 ) ml vs ( 175 ±53 ) ml, LVESV : ( 149 ± 57 ) ml, ( 160 ± 59) ml vs ( 124 ± 56 ) ml, P ＜ 0.01], and with the degree of heart failure increased,the more obvious changes. Conclusion TH changes have great significance on cardiac function damage,treatment and prognosis of patients with CHF.