神经肽Y及心肌肌钙蛋白T在甲状腺功能亢进性心脏病中的意义

Diagnostic Significance of Cardial Troponin T and Neuro peptide Y in Hyperthyroic Heart Disease

摘要:

目的： 探讨神经肽Y(NTY)心肌肌钙蛋白T(cTnT)在甲状腺功能亢进 (甲亢 )性心脏病诊断中的意义。方法： 对我院 1998年 1月至 1999年 1月诊治的甲亢 2 3例,分别在治疗前、后进行NTY ,cTnT ,游离T3 ,游离T4 (FT3 ,FT4 ) ,促甲状腺素 (TSH)以及检测代表左心射血功能的指标心脏指数 (CI)和射血分数 (EF) ,并进行相关性对比。结果： NTY治疗前升高 192 .8± 7.1ng/L ,治疗后降至正常,t=2.185,P <0 .05,差异有显著性。cTnT治疗前仅 6例升高 0 .13± 0 .0 4ng/L ,治疗后均降至正常,t =2 .0 8,P <0 .0 5 ,差异有显著性。治疗前EF有9/ 2 3例减低,治疗 4周后 8/13例恢复正常。NTY与CI,EF均成反比,其相关系数分别为- 0 .333,- 0 .2 0 3。结论： NTY ,cTnT在甲亢心脏病中均升高,NTY对心脏有负性肌力作用。甲亢性心脏病存在神经内分泌调节引起的继发性缺血性改变,只要治疗及时可以痊愈。

Abstract:

OBJECTIVE: To study the value of cardial troponin T (cTnT) and neuro peptide Y (NTY) in hyperthyroic heart disease. METHODS: The concentrations of serum cTnT and NTY were measured by ELISA method in 23 patients with hyperthyroidism, and were correlated with the myocardial systolic functions (cardic index, CI; ejective fration, EF) before and after the treatment. RESULTS: The concentrations of cTnT, NTY, FT 3, FT 4 and blood pressure (BP) at the beginning were 0.13 ± 0.04 ng/L, 192.8 ± 7.1 ng/L, 36.79 ± 4.94 ng/L, 52.96 ± 16.18 ng/L and 123.69 ± 10.06 mmHg, which after the treatment were 0.06 ± 0.03 ng/L, 140.2 ± 5.1 ng/L, 11.52 ± 4.74 ng/L, 26.81 ± 5.18 ng/L and 105.00 ± 8.66 mmHg while TSH was lower at the beginning ( 1.21 ± 0.45 U/L) than after the treatment (1.84 ± 0.29 U/L) in hyperthyroidism (t= 2.185 , 2.08, 13.3, 4.53 and 4.84, respectively). The myocardial systolic functions were damaged in hyperthyroidism. The interrelations between NTY and CI, EF were negative in hyperthyroidism (r= -0.333 and -0.203 , Y= 276.21 - 21.785 X; Y= 0.632 - 2.902 X, respectively). CONCLUSIONS: The concentrations of NTY and cTnT are higher in hyperthyroic heart disease. The higher the NTY and cTnT concentrations, the worse the myocardial systolic functions.