摘要
目的研究冠状动脉搭桥患者术前、术中、术后甲状腺激素的动态变化。方法对30名健康志愿者于空腹时、62例冠心病患者于术前、术中及术后定时采血，用化学发光法及放射免疫法测定TT3、TT4、FT3、FT4、TSH、rT3水平，并以SPSS 10．0进行统计分析。结果术前患者的甲状腺激素水平与正常对照组之间差异无统计学意义；术中肝素化后10min及60min时，TT4、FT4水平显著高于术前（P〈0．01），而术后2hTT3，TT4、FT3、FT4、rT3、TSH水平无显著变化；术后24h和72hTT3、TT4、FT3、FT4、TSH水平显著低于术前（P〈0．01），24hTT3、FT3较术前分别下降了52．7％和46．6％，而几水平显著高于术前（P〈0．01）；木后7dTT3、rT3水平显著低于术前（P〈0．01），TT4、FT3、FT4、TSH浓度仍未恢复到术前正常浓度水平。结论冠状动脉搭桥术中患者的血清TT4、FT4水平升高，术后血清TT3、FT3水平降低可能提示预后不良。
Objective To clarify the change of serum thyroid hormone levels during periopreation period of coronary artery bypass grafts （CABG）. Methods The levels of serum thyroid hormones （ TT3 , TT4, FT3, FT4, TSH, rT3） were measured by chemical-luminal and RIA in 62 patients at certain time in perioperation period, as well as 30 normal volunteers on a fasting basis. SPSS 10. 0 was used for statistic analysis. Results The levels of serum thyroid hormones had no significant difference between controls and patients before CABG. At 10 min and 60 min after giving heparin,serum TT4, FT4 levels in patients during operation elevated significantly than before （ P 〈 0. 01 ） , however, at 2 h after operation, serum TT3 , TT4, FT3, FT4, rT3 , TSH levels had no significant changes. Serum TT3 , TT4, FT3 , FT4, TSH levels at 24 h and 72 h after operation were significantly lower in patients than before CABG （ P 〈 0. 01 ） . Especially at 24 h, serum TT3 ,FT3 levels decreased by 52.7% and 46. 6% than before respectively, while serum rT3 levels increased significantly （ P 〈 0. 01 ） and serum TT3 , rT3 levels decreased significantly （ P 〈 0. 01 ）. The serum TT4, FT3, FT4, TSH levels didn＇t return to normal at 7 d after operation. Conclusion Elevated serum TT4, FT4 levels are present in acute period in patients accepted CABG. Decreased serum T3 and FT3 levels after CABG may indicate a bad prediction.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2009年第39期2783-2785,共3页
National Medical Journal of China
关键词
冠状动脉分流术
手术期间
甲状腺激素类
Coronary artery bypass
Intraoperative period
Thyroid hormones
