| Congestive heart failure ( CHF) is a common disease that can harm health of human. A lot of clinical and epidemic disease investigation suggest;CHF has not been simple hemodynamics barrier,but it is clinical syndrome of activating a lot of nerve and body fluid factor.So changes of thyroid hormone (T3) and troponinl(cTnl) also are paid close attention in the congestive heart failure, however, the study comparing the two targets simultaneously has been not completed. The article surveys blood serum T3and cTnl of CHF patients and healthy people at the same time and pretherapy and posttherapy of CHF. We want probe into the relate between blood serum T3 and cTnl.MethodsAll 60 patients, who are diagnosed CHF,27 men , 33 women, aged from 41 to 83 years old. They are divided into three groups by degree of heart failure. Every group is 20 people. All selective patients exceped thyropathy and have not taken medicine of thyroid for recency (two weeks). We also select 30 healthy people as normal group.The clinical data include age, sex, weight, heart failure history and symptom.Those selective patients are surveyed the amount of blood serum T3and cTnI before treatment and after treatment by chemical fluorescence immunosorbent.Statistical analysis is performed by t test. For categorical data, X2 test is used. Between T3 and cTnI correlative analysis is used.ResultsThe sex, age, history, weight of three groups CHF is equal. There is no remarkable difference( p > 0. 05 ).In clinical data, the amount of blood serum T3 lowers and cTnl rises remarkably in 60 CHF( p <0. 01). There is a great change among different levels of CHF( p < 0. 05 ). After CHF improvement, blood serum T3 has been risen remarkably and blood serum cTnl has been lowered remarkably too, which is contrasted to untreatment, difference is significant( p <0. 01) ; which is contrasted to healthy group, difference is no significant (p >0. 05). Through correlative analysis,there is a clear negative correlation between T3 and cTnl is shown( r = -0.704, p<0.01).Disscussion1 Relation of blood serum T3and CHFRecent change of thyroid hormone has cause thought of people in CHF. Engslon discovered the first time in 1955 thyroid hormone lowered in some serious disease of nonthyroid gland, however TSH was normal,there is symptom of hypothyrodism in clinic,we call it"normal thyroid gland function abnormal state syndrome" ( ESS). Recentyears, there are some similar reports in some diseases of cardiovascular. The article suggest; blood serum T3 has been lowered remarkly, which is contrasted to healthy group. There is a great change among different levels of CHF patients ( p < 0. 05 ). The mechanisms of decrease of thyroid hormone in CHF are (1)stress, hypoxia, acdiosis and lesion of myocardium use of T3 increase in tissue. (2)Deficiency of nutrient substance. (3)Change of thyroid hormone receptor. (4) Deficiency of thyroid tissue blood interferes synthesis and release of thyroid hormone. (5) Stress state of body in CHF increases excretion of cate-cholamine, glucocorticoid and cortisol, and inhibit 5' - deiodination enzyme. (6)Increase of TNF concentration in CHF which may block the excitation of TSH and thyroid cell, however it can not kill thyroid cell directly, makes T3, T4 lower. (7)Up - regulation of nucleus receptor in CHF needs a lot of T3 ,so plasm T3 concentration descent. (8)there is a kind of thyroid inhibitive factor in renal hypertension and it can inhibit thyroid absorbs I and activity of peroxidase and cause descent of thyroid function and hypofunction of thyroid axis. (9)Activity of 5' -deiodination enzyme is inhibited remarkably.2 Relation of blood serum cTnI and CHFTroponin is a kind of regulation protein which relates to myocardium and skeletal muscles. It consists of three subunits. They are Tnl, TnT and TnC. TnI is divided into fsTnI,ssTnI and cTnl. In cardiac muscle cell integrity, cTnl can not go into blood circulation from cell membrane. When cardiac muscle cell injure, cTnl may go into blood circulation. Exc...
|
PDF Full Text Request