原发性甲状腺机能减退患者心肌酶改变的分析

目的观察甲状腺机能减退(甲减)患者血清心肌酶的变化以及与临床指标间的关系。方法测定了108例甲减患者的心肌酶水平,其中桥本甲状腺炎31例、萎缩性甲状腺炎28例、Graves甲亢经131Ⅰ治疗24例、Graves甲亢经抗甲状腺药物治疗25例,并与50例正常对照者进行了比较。结果甲减患者血清中各种心肌酶包括肌酸激酶(CK)及其同工酶(CK-MB)、天门冬氨酸转氨酶(AST)、乳酸脱氢酶(LDH)、α-羟丁酸脱氢酶(HBDH)水平显著升高,以CK为著(P<0.05),且CK、CK-MB水平与游离三碘甲状腺原氨酸(FT3)、血清游离甲状腺素(FT4)水平呈显著负相关;不同病因所致的甲减组之间各种酶水平的比较未显示明显不同。结论甲状腺机能减退症可致心肌酶活性改变,且CK、CK-MB升高的幅度与甲减的程度有关,可作为判断甲减病情的指标。

Changes in myocardial enzymes in serum of patients with primary hypothyroidism

Objective To investigate the changes in serum level of myocardial enzymes in patients with primary hypothyroidism and to evaluate the relationship between the level of those enzymes and clinical or experimental parameters.Methods We measured several myocardial enzymes in serum of 108 patients with primary hypothyroidism including 31 cases of Hashimoto's thyroiditis,28 cases of atrophic thyroiditis,24 cases of Graves' hyperthyroidism treated by 131I,and 25 cases of Graves' hyperthyroidism treated by antithyroid drugs,as well as 50 normal controls.Results All the myocardial enzymes,including creatine kinase(CK) and its isoenzyme CK-MB,aspartate aminotransferase(AST),lactate dehydrogenase(LDH) and its isoenzyme HBDH,especially CK,were elevated in serum of patients with hypothyroidism.In addition,significant negative correlations were found between CK and FT3,CK and FT4,CK-MB and FT3,CK-MB and FT4.No difference in enzyme level was found among different hypothyroidism groups.Conclusion Hypothyroidism may cause elevation of myocardial enzymes in serum of the patients.The degree of CK and CK-MB increase was associated with the severity of hypothyroidism,and thus can be regarded as indexes to determine the severity of hypothyroidism.