Sinci V, Soncul H, Gunaydin S, Halit V, Gokgoz L, Tatlican O, Yener A, Bilgehan A, Ersoz A
Department of Cardiovascular Surgery, Gazi University, School of Medicine, Ankara, Turkey.
Jpn Heart J. 1994 Jul;35(4):443-54. doi: 10.1536/ihj.35.443.
Cardiopulmonary bypass is associated with a reduction in plasma thyroid hormone concentrations in patients undergoing cardiac surgery. However, studies of the effects of cardiopulmonary bypass on thyroid function are limited and many studies report conflicting data concerning only the period of cardiopulmonary bypass. In this study, we tried to clinically determine the effects of cardiopulmonary bypass on concentrations of thyroid hormones by comprehensive thyroid function tests in 10 patients before and after surgery, and observed the benefits of triiodothyronine supplementation after global ischemia on myocardial function experimentally in guinea pigs. In patients undergoing surgery, concentrations of total triiodothyronine and free triiodothyronine decreased progressively on the institution of cardiopulmonary bypass and remained below normal levels until 24 hours postoperatively. In the guinea pig hearts studied in a Langendorf perfusion apparatus, T3 supplementation enhanced percentage recovery of ventricular contractile force, heart work and heart rate with respect to other groups receiving no T3 supplementation or T3 supplementation without any ischemic interval.
体外循环与心脏手术患者血浆甲状腺激素浓度降低有关。然而，关于体外循环对甲状腺功能影响的研究有限，许多研究仅报告了关于体外循环期间相互矛盾的数据。在本研究中，我们试图通过对10例患者手术前后进行全面的甲状腺功能测试，从临床角度确定体外循环对甲状腺激素浓度的影响，并在豚鼠身上通过实验观察全脑缺血后补充三碘甲状腺原氨酸对心肌功能的益处。在接受手术的患者中，体外循环开始后总三碘甲状腺原氨酸和游离三碘甲状腺原氨酸浓度逐渐下降，并在术后24小时一直低于正常水平。在用Langendorff灌注装置研究的豚鼠心脏中，与未补充T3或未经过任何缺血间隔就补充T3的其他组相比，补充T3提高了心室收缩力、心脏做功和心率的恢复百分比。
