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Patients with coronary heart disease and acute myocardial infarction of thyroid hormone levels


Thyroid function. T3 and T4 determination of significance is not clear. Because many factors can affect the determination of T3 and T4 values, these factors include changes in thyroid hormone synthesis and secretion, serum binding protein and its concentration does not change the saturation, T4 into T3 iodothyronine and so on. Disease, thyroid hormone levels can change. Wartofsky, etc. ¨ 2] suggest a on thyroid hormone levels. Many scholars have studied in critically ill patients l3 ~ decrease in serum T3 and disease prognosis, that the severity of the disease they are associated, and the prognosis of these patients for observation. The results show, T3, hs-TSH and that disease severity and prognosis, especially in the more serious condition T3, T3 lower the value, moderate,[link widoczny dla zalogowanych], mild and severe patients than in T3 was significantly lower in patients 35 or so. The main reason is the heart insufficiency, liver damage in varying degrees, 5 '. . Iodothyronine activity decreased, resulting in internal environment iodothyronine T4, T4 into T3 reduced; as heart failure, due to hypoxia, acidosis, myocardial damage, etc., can make use of T3 in the organization increased, decreased serum T3 ; chronic coronary heart failure, multiple organ damage,[link widoczny dla zalogowanych], the body is in severe stress, increased cortisol,[link widoczny dla zalogowanych], suppressed thyrotropin-releasing hormone (TRH) secretion and inhibition of hs-TSH to the TRH stimulation of, lead to low levels of hs-TSH, T3 decreased. AMI patients with severe thyroid-stimulating hormone (TSH) in the past that the normal or elevated. These patients at the onset of thyroid and pituitary function before the normal thyroid function after rehabilitation can return to normal. Some patients with severe clinical manifestations of AMI suggest a low, with the increase in the severity of AMI, until the patients died,[link widoczny dla zalogowanych], getting lower and lower levels of serum T4. This was mainly due to thyroglobulin (T4 a TBG) binding affinity of the loss. Also in the basis of low TSH secretion in diabetic patients, the pituitary response to the T4 is low, may be low on the TRH response, of such patients, if the TSH assay with low sensitivity may be undetectable TSH, thyroid function and can not diagnose whether the low The use of hs-TSH analysis can be measured to the TSH, which can rule out hypothyroidism. Patients with severe low TSH response to TRH was mainly due to the depth of the lower inhibitory effect. Many cardiovascular diseases can cause the body changes in serum thyroid hormone levels, foreign literature [1 a. Mainly as serum T3 concentration was decreased, FT3, T4, FT4 concentration, TSH levels were normal or decreased, but the clinical manifestations in patients with normal thyroid function, called Studies have West change, FT3, FT4 generate increased; ② AMI clearance rate increased when T3, resulting in reduced blood levels of T3; ③ when the long-term hypoxia with heart failure, gastrointestinal stasis, eating small, nutrient deficiency leads to thyroid hormone synthesis and metabolism of obstacles, and finally to the low level of thyroid hormone the body. Some studies showed that low T3 syndrome, critical illness may be the result of injury, critically ill patients with low T3 are often prompted to severe illness, a poor prognosis. This observation indicates that coronary heart disease, AMI onset reduce the level of post-T3, hs-TSH levels of more significant changes,[link widoczny dla zalogowanych], indicating that the T3 and hs-TSH levels in patients with coronary heart disease, AMI severity of the disease related. The symptoms disappeared after treatment, the condition improves significantly higher than that before treatment T3, FT3, T4, FT4 decreased significantly. that changes in thyroid hormone levels to determine coronary heart disease, AMI patient's condition and prognosis I have some clinical value.