陈立华 石凤梧 张中馥 刘绍贤 谢英奎 张文立 陈立华 石凤梧 张中馥 刘绍贤 谢英奎(050000 石家庄，河北医科大学第二医院心外科)；张中馥(河北省第五人民医院) 中华实验外科杂志 2000 0 17 1


    关键词：体外循环；心脏手术；低T₃ 综合征 期刊 zhsywkzz 0 46-47 临床研究 fur -->


    

【摘要】 目的 观察体外循环心脏手术前后甲状腺激素的变化，研究其对甲状腺激素代谢的影响。方法 用放射免疫法测定30例体外循环心脏手术患者术前、术中、术后血浆甲状腺激素和促甲状腺激素的浓度。结果 三碘甲状腺原氨酸(T₃ )、甲状腺素(T₄ )、游离三碘甲状腺原氨酸(FT₃ )术中降低，术后2 h T₄ 恢复正常。T₃ 、FT₃ 呈下降低趋势，术后24 h降至最低(P<0.01)。FT₄ 手术前后差异无显著性，rT₃ 术后24 h明显升高。TSH术后降低。结论 体外循环心脏手术对甲状腺激素代谢有严重的影响，术中为低T₃ 、低T₄ 综合征，术后为低T₃ 综合征。

Influences of open heart surgery under

    cardiopulmonary bypass on thyroid hormones

CHEN Lihua^* , SHI Fengwu, ZHANG Zhongfu, et al.

    ( ^* Department of Cardiac Surgery, Second Hospital of Hebei Medical College, Shijiazhuang 050000,China)

【 Abstract】 Objective To study the changes of perioperative serum thyroid hormones (TH) and the effects of open heart surgery under cardiopulmonary bypass on TH. Methods Serum TH (T₃ , T₄ , FT₃ , FT₄ , rT₃ ) and thyroid-stimulating hormone (TSH) were determined by using radioimmunoassay pre-, peri- and post-operativly in 30 patients undergoing open heart surgery under cardiopulmonary bypass. Results T₃ , T₄ and FT₃ levels were declined during operation and T₄ returned to normal at 2 h after operation. T₃ and FT₃ were continuously declined and reached the lowest at 24 h after operation (P<0.01). No significant changes in FT₄ level were found before and after operation. rT₃ was significantly increased at 24 h after operation. TSH was declined after operation. Conclusion Open heart surgery under cardiopulmonary bypass had significant influences on TH, showing “low T₃ , T₄ syndrome” during operation and “ low T₃ syndrome” after operation.

    【 Key words】 Cardiopulmonary bypass; Heart surgery; Low T₃ syndrome

体外循环(cardiopulmonary bypass, CPB)心脏手术可出现低三碘甲状腺原氨酸(T₃ )综合征 ......