Nishino M, Kimura T, Kanda T, Kotajima N, Yoshida A, Kuwabara A, Tamama K, Fukumura Y, Kobayashi I
Department of Laboratory Medicine and Clinical Laboratory Center, Gunma University School of Medicine, Maebashi, Japan.
J Endocrinol Invest. 2000 Sep;23(8):509-14. doi: 10.1007/BF03343766.
To investigate relationships between thyroid states and the cardiac endocrine system, we analyzed thyrotropin (TSH), thyroid hormone, plasma levels of interleukin-6 (IL-6) and brain natriuretic peptide (BNP) in 50 patients with chronic heart failure (CHF), in 30 patients with heart failure from acute myocardial infarction (AMI), and in 15 controls. Plasma levels of IL-6 and BNP in both CHF and AMI were significantly elevated, while free triiodothyronine (FT3) was significantly decreased compared to controls. FT3/free thyroxine (FT4) ratio was significantly decreased in CHF but not in AMI compared to controls. In CHF, diuretic treatment diminished circulating BNP but not IL-6, while diuretic treatment increased FT3/FT4 ratio. In AMI, FT3/FT4 ratio was significantly decreased 72 h compared to 12 h after the onset of AMI, while BNP and IL-6 were significantly increased 72 h compared to 12 h after the onset of AMI. In both CHF and AMI, BNP significantly correlated with FT4. On the other hand, significant correlations between IL-6 and FT3, and between IL-6 and FT3/FT4 ratio were detected in AMI but not in CHF. This preliminary study suggests that IL-6, BNP and thyroid hormone reflect ventricular dysfunction in both acute and chronic heart failure, and that IL-6 significantly relates to circulating thyroid hormone in AMI but not in CHF.
为了研究甲状腺状态与心脏内分泌系统之间的关系,我们分析了50例慢性心力衰竭(CHF)患者、30例急性心肌梗死(AMI)所致心力衰竭患者及15例对照者的促甲状腺激素(TSH)、甲状腺激素、血浆白细胞介素-6(IL-6)和脑钠肽(BNP)水平。CHF组和AMI组的血浆IL-6和BNP水平均显著升高,而与对照组相比,游离三碘甲状腺原氨酸(FT3)显著降低。与对照组相比,CHF组的FT3/游离甲状腺素(FT4)比值显著降低,而AMI组则无明显变化。在CHF组,利尿治疗可降低循环BNP水平,但对IL-6水平无影响,而利尿治疗可提高FT3/FT4比值。在AMI组,与AMI发病后12小时相比,发病后72小时FT3/FT4比值显著降低,而BNP和IL-6则显著升高。在CHF组和AMI组中,BNP均与FT4显著相关。另一方面,在AMI组中检测到IL-6与FT3以及IL-6与FT3/FT4比值之间存在显著相关性,而在CHF组中未检测到。这项初步研究表明,IL-6、BNP和甲状腺激素反映了急性和慢性心力衰竭中的心室功能障碍,并且IL-6在AMI中与循环甲状腺激素显著相关,而在CHF中则不然。