De Marinis L, Mancini A, Masala R, Torlontano M, Sandric S, Barbarino A
J Endocrinol Invest. 1985 Dec;8(6):507-11. doi: 10.1007/BF03348548.
We have studied with seriated controls for a period of 9 days 18 patients admitted to our hospital for acute myocardial infarction (AMI). Slight, but non significant variations in thyroidal hormone pattern were observed: slight decrease of T3 and T4 levels, increase of reverse T3 on day 3, low free T4 levels, slight increase of TSH levels until the 3rd day. However, hormonal pattern was clearly different in patients who presented a clinical improvement (group 1a) and in patients who died for AMI (group 1b). In fact, a significant TSH increase was recorded in patients of group 1a; on the contrary, a significant decrease of TSH, T4 and free T4 concentrations was observed for subjects of group 1b, suggesting an inadequate response of pituitary-thyroid axis. In conclusion, the evaluation of thyroid hormones and thyrotropin levels can be of clinical usefulness in the management of patients with AMI. The decrease of plasma T4 and free T4 concentrations, accompanied with low TSH levels, can be associated with unfavorable course of the disease and therefore can be considered a bad prognostic sign.
我们对我院收治的18例急性心肌梗死（AMI）患者进行了为期9天的系列对照研究。观察到甲状腺激素模式有轻微但无显著变化：T3和T4水平略有下降，第3天反T3升高，游离T4水平降低，TSH水平在第3天前略有升高。然而，临床症状改善的患者（1a组）和死于AMI的患者（1b组）的激素模式明显不同。事实上，1a组患者的TSH显著升高；相反，1b组患者的TSH、T4和游离T4浓度显著降低，提示垂体-甲状腺轴反应不足。总之，评估甲状腺激素和促甲状腺激素水平对AMI患者的治疗可能具有临床意义。血浆T4和游离T4浓度降低，同时TSH水平较低，可能与疾病的不良病程相关，因此可被视为不良预后指标。
