Li Xin, Wang Huai-Bin, Yao Zhi-Ming, Zheng Jian-Guo, Zhong Wei-Duan
Department of Nuclear Medicine, Beijing Hospital, China Ministry of Health, Beijing 100730, China.
Zhonghua Yi Xue Za Zhi. 2009 Oct 27;89(39):2783-5.
To clarify the change of serum thyroid hormone levels during perioperation period of coronary artery bypass grafts (CABG).
The levels of serum thyroid hormones (TT(3), TT(4), FT(3), FT(4), TSH, rT(3)) were measured by chemical-luminal and RIA in 62 patients at certain time in perioperation period, as well as 30 normal volunteers on a fasting basis. SPSS 10.0 was used for statistic analysis.
The levels of serum thyroid hormones had no significant difference between controls and patients before CABG. At 10 min and 60 min after giving heparin, serum TT(4), FT(4) levels in patients during operation elevated significantly than before (P < 0.01), however, at 2 h after operation, serum TT(3), TT(4), FT(3), FT(4), rT(3), TSH levels had no significant changes. Serum TT(3), TT(4), FT(3), FT(4), TSH levels at 24 h and 72 h after operation were significantly lower in patients than before CABG (P < 0.01). Especially at 24 h, serum TT(3), FT(3) levels decreased by 52.7% and 46.6% than before respectively, while serum rT(3) levels increased significantly (P < 0.01) and serum TT(3), rT(3) levels decreased significantly (P < 0.01). The serum TT(4), FT(3), FT(4), TSH levels didn't return to normal at 7 d after operation.
Elevated serum TT(4), FT(4) levels are present in acute period in patients accepted CABG. Decreased serum T(3) and FT(3) levels after CABG may indicate a bad prediction.
明确冠状动脉旁路移植术（CABG）围手术期血清甲状腺激素水平的变化。
采用化学发光法和放射免疫分析法，在围手术期的特定时间点测量62例患者以及30例空腹正常志愿者的血清甲状腺激素水平（TT(3)、TT(4)、FT(3)、FT(4)、TSH、rT(3)）。使用SPSS 10.0进行统计分析。
CABG术前患者与对照组血清甲状腺激素水平无显著差异。给予肝素后10分钟和60分钟，术中患者血清TT(4)、FT(4)水平较术前显著升高（P < 0.01），然而，术后2小时，血清TT(3)、TT(4)、FT(3)、FT(4)、rT(3)、TSH水平无显著变化。术后24小时和72小时患者血清TT(3)、TT(4)、FT(3)、FT(4)、TSH水平显著低于CABG术前（P < 0.01）。尤其是术后24小时，血清TT(3)、FT(3)水平分别较术前下降52.7%和46.6%，而血清rT(3)水平显著升高（P < 0.01），血清TT(3)、rT(3)水平显著下降（P < 0.01）。术后7天血清TT(4)、FT(3)、FT(4)、TSH水平未恢复正常。
接受CABG的患者急性期血清TT(4)、FT(4)水平升高。CABG术后血清T(3)和FT(3)水平降低可能提示预后不良。
