摘要
目的：探讨慢性肺源性心脏病机械通气患者血清甲状腺激素的变化及其意义。方法：应用放免方法测定了３７ 例慢性肺源性心脏病机械通气患者和３３ 例正常对照者血清三碘甲状腺原氨酸（Ｔ３ ）、甲状腺素（Ｔ４ ）和促甲状腺激素（ＴＳＨ）。结果：慢性肺源性心脏病急性发作期患者血清Ｔ３ 和Ｔ４ 明显低于正常对照组（Ｐ均＜０．０５），而ＴＳＨ明显高于正常对照组（Ｐ＜ ０．０５）。机械通气２４小时内血清Ｔ３、Ｔ４ 和ＴＳＨ 较通气前明显降低（Ｐ均＜ ０．０５）。在撤机前血清Ｔ３ 和Ｔ４ 较通气前明显升高（Ｐ均＜ ０．０５），而ＴＳＨ降低（Ｐ＜ ０．０５）。２８例撤机成功者血清Ｔ３ 和Ｔ４ 明显高于９例撤机失败者（Ｐ均＜ ０．０５），而ＴＳＨ ２组患者无明显差异。结论：慢性肺源性心脏病患者血清Ｔ３ 和Ｔ４ 明显低于正常人，机械通气可引起短暂的继发性甲状腺功能低下，测定血清Ｔ３ 和Ｔ４ 可预计机械通气患者撤机成败。
Objective:To investigate the changes in serum thyroid hormones in patients with chronic cor pulmonale under mechanical ventilation and its clinical significance.Methods:The levels of serum triiodothyronine(T 3),thyroxine (T 4) and thyrotropin (TSH) were measured by radioimmunoassay in 37 patients with chronic cor pulmonale undergoing mechanical ventilation and 33 healthy subjects.Results:The data showed that the levels of serum T 3 and T 4 were significantly lower in 37 patients with chronic cor pulmonale than those in 33 normal controls ( P <0 05),whereas the level of serum TSH was significantly higher in 37 patients with chronic cor pulmonale than that in 33 normal controls ( P <0 05).The levels of serum T 3,T 4 and TSH were significantly decreased within 24 hours after mechanical ventilation(all P <0 05).The levels of serum T 3 and T 4 were significantly increased(all P <0 05),and the TSH was significantly decreased( P <0 05) prior to weaning.The level of serum T 3 and T 4 were significantly higher in 28 patients who could be successfully weaned than those in 9 patients who could not be successfully weaned(both P <0 05),and the TSH showed no significant difference between patients who weaned successful and those who failed ( P >0 05).Conclusions:The level of serum T 3 and T 4 were signifcantly decreased in patients with chronic cor pulmonale.Mechanical ventilation may contribute to transient secondary hypothyoidism.The detection of serum T 3 and T 4 can be used to predict whether weaning from mechanical ventilation would be successful or not.
出处
《中国危重病急救医学》
CAS
CSCD
2000年第1期31-32,共2页
Chinese Critical Care Medicine
关键词
机械通气
甲状腺激素
肺心病
测定
chronic cor pulmonale
mechanical ventilation
thyroid hormone
