论文部分内容阅读
目的探讨充血性心力衰竭 (CHF)患者心率变异性 (HRV)与血清甲状腺激素的关系。方法应用Holter心电图自动分析系统对 5 5例CHF患者及 4 2例正常对照者的HRV频域及时域进行分析 ,同时用放免法测定甲状腺激素水平。结果CHF患者中 ,血清T3 减低 (P <0 .0 5 ) ,而rT3 水平升高 (P <0 .0 1) ;HRV指标SDNN ,rMSSD ,LF和HF水平降低 (P <0 .0 5 ) ,而LF/HF比值升高 (P <0 .0 5 )。在这些变化中以低T3 的CHF组表现更明显 (P <0 .0 1)。结论心力衰竭患者存在继发性甲状腺代谢紊乱 ,低T3 及高rT3 水平可作为评价心力衰竭患者病情及预后的指标之一 ;心力衰竭患者自主神经调节功能明显受损 ,迷走神经张力减低 ,交感神经张力升高。交感神经及迷走神经受损在低T3 心力衰竭患者中表现更明显 ,故纠正甲状腺激素代谢紊乱 ,使自主神经平衡紊乱得到改善 ,有利于改善心力衰竭患者的预后。
Objective To investigate the relationship between heart rate variability (HRV) and serum thyroid hormone in patients with congestive heart failure (CHF). Methods The HRV frequency domain and time domain of 55 CHF patients and 42 normal controls were analyzed by Holter electrocardiogram automatic analysis system. Thyroid hormone levels were measured by radioimmunoassay. Results Serum T3 decreased (P <0.05) and rT3 increased (P <0.01) in CHF patients. The levels of SDNN, rMSSD, LF and HF in HRV decreased (P <0.05) , While the LF / HF ratio increased (P <0.05). In these changes, the performance was more pronounced in the low-T3 CHF group (P <0.01). Conclusions There are secondary thyroid metabolic disorders in patients with congestive heart failure. Low T3 and high rT3 levels can be used as indicators to evaluate the prognosis and prognosis of patients with congestive heart failure. Autonomic nervous system dysfunction is significantly impaired in patients with heart failure, vagal tone is reduced, sympathetic tone Rise. Sympathetic and vagal impaired in patients with low T3 heart failure performance is more obvious, so to correct thyroid hormone metabolism disorders, autonomic nervous balance disorders are improved, help to improve the prognosis of patients with heart failure.