摘要
目的探讨T3(三碘甲状腺原氨酸)、T4(四碘甲状腺原氨酸)及TSH(促甲状腺激素)测定在慢性肺源性心脏病机械通气患者中的变化及临床意义。方法采用放射免疫分析法(IRMA)测定80例慢性肺源性心脏病机械通气前后及110例肺良性疾病患者血清T3、T4及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<0.05),而TSH明显高于正常对照组(P<0.05)。机械通气24h内血清T3、T4和TSH较通气前明显降低(P<0.05)。72h后至撤机前T3、T4和TSH逐渐升高。62例撤机成功血清T3和T4明显高于18例撤机失败者(P<0.05)。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,随着病情改善T3、T4逐渐升高。测定血清T3和T4可预估机械通气患者撤机成败,在临床中对判断预后有重要指导意义。
Objective To explore the clinical value of serum thyroid hormones in chronic corpulmonale patients with mechanical ventilation. Methods IRMA was utilized to determine T3 ,T4 and TSH on 80 chronic corpulmonale patients with mechanical ventilation （ experimental group） and 110 patients of benign lung disease （ contrast group）. Results The data showed that the levels of serum T3 and T4 were significantly lower in the experimental group than the contrast group （P 〈 0. 05 ）. The levels of serum T3, T4 and TSH significantly decreased within 24 hours after mechanical ventilation （P 〈 0. 05 ）, but after 72 hours the levels of serum T3 and T4 significantly increased （P 〈0. 05）. The level of serum T3 and T4 were significantly higher in 62 patients who could be successfully weaned than those in 18 patients who could not be successfully weaned（ P 〈 0.05 ）. Conclusion The level of serum T3 and T4 significantly decreased in patients with chronic cor pulmonale. Mechanical ventilation may contribute to transient secondary hypothyroid. The detection of serum T3 and T4 can be used to predict whether weaning from mechanical ventilation would be successful or not, and it can be applied to reflect the patient＇ s condition and to assess prognosis.
出处
《临床肺科杂志》
2010年第1期46-47,共2页
Journal of Clinical Pulmonary Medicine
