Salter D R, Dyke C M, Wechsler A S
Department of Surgery, Medical College of Virginia, Richmond 23219.
J Card Surg. 1992 Dec;7(4):363-74. doi: 10.1111/j.1540-8191.1992.tb01029.x.
Hypothyroidism is associated with an abnormal hemodynamic state characterized by decreased heart rate, stroke volume, output, and contractility, and increased systemic vascular resistance. Since cardiopulmonary bypass (CPB) and surgical stress can induce profound decreases in triiodothyronine (T3) levels, the hemodynamic consequences of "stress-induced" hypothyroidism and T3 repletion are of increasing clinical interest. Available data generally support the likelihood of a beneficial effect associated with T3 replacement in brain-dead organ donors and in cases of low cardiac output following CPB. Although hypotheses have been advanced to account for these salutary effects, the mechanism by which T3 may augment hemodynamic performance has not been precisely defined, particularly in the acute setting. Although additional research is needed to clarify these and other issues, preliminary findings with T3 replacement indicate that such investigation is warranted.
甲状腺功能减退与异常的血流动力学状态相关，其特征为心率、每搏输出量、心输出量和心肌收缩力降低，以及全身血管阻力增加。由于体外循环（CPB）和手术应激可导致三碘甲状腺原氨酸（T3）水平大幅下降，“应激性”甲状腺功能减退和T3补充的血流动力学后果在临床上越来越受到关注。现有数据普遍支持在脑死亡器官供体和CPB后心输出量低的情况下，T3替代可能产生有益效果。尽管已经提出了一些假说来解释这些有益作用，但T3增强血流动力学性能的机制尚未明确界定，尤其是在急性情况下。尽管需要进一步研究来阐明这些及其他问题，但T3替代的初步研究结果表明这种研究是有必要的。
