Dyke C
University of Pittsburgh Medical Center, PA 15213, USA.
Curr Opin Cardiol. 1996 Nov;11(6):603-9. doi: 10.1097/00001573-199611000-00008.
Cardiopulmonary bypass has been demonstrated to produce a state of functional hypothyroidism characterized by low levels of circulating tri-iodothyronine and elevated levels of reverse Tri-iodothyronine. This low tri-iodothyronine state may have significant hemodynamic consequences similar to that seen with chronic hypothyroidism. In a number of experimental models, evidence has accumulated suggesting that tri-iodothyronine supplementation to the ischemically injured heart enhances ventricular contractile performance. Clinically, tri-iodothyronine supplementation after cardiac surgery improves hemodynamics, although the population of patients who might benefit from this unconventional therapy remains unclear. In this article, the rationale and experimental evidence for the use of tri-iodothyronine during cardiac surgery are reviewed.
体外循环已被证明会导致一种功能性甲状腺功能减退状态，其特征为循环中三碘甲状腺原氨酸水平降低以及反式三碘甲状腺原氨酸水平升高。这种低三碘甲状腺原氨酸状态可能会产生与慢性甲状腺功能减退相似的显著血流动力学后果。在一些实验模型中，已有证据表明，向缺血性损伤的心脏补充三碘甲状腺原氨酸可增强心室收缩功能。临床上，心脏手术后补充三碘甲状腺原氨酸可改善血流动力学，尽管可能从这种非常规治疗中获益的患者群体尚不清楚。在本文中，我们将对心脏手术期间使用三碘甲状腺原氨酸的理论依据和实验证据进行综述。
