【摘要】 目的：了解风湿性心脏病换瓣和先天性心脏病人心内直视手术期间甲状腺激素的变化并探讨其临床意义。方法：３５例行心内直视手术病人，其中风心组１９例，先心组１６例，用放免法分别于诱导前、后及术毕测定Ｔ３、Ｔ４、ＦＴ３、ＦＴ４、及ＴＳＨ。结果：两组病人术毕Ｔ３、ＦＴ３显著低于术前；风心组术前、术毕Ｔ３、ＦＴ３均显著低于先心组；风心组心功能Ⅳ级病人术前、术毕Ｔ３均显著低于心功能Ⅱ～Ⅲ级者。结论：我们认为，Ｔ３替代疗法主要适用于术前心功能较差的病人。更多还原

【Abstract】 Objective:To investigate the changes of thyroid hormone levels in patients with valve replacement and congenital heart surgery. Methods:Thirty five patients with open heart surgery were studied. Among them nineteen underwent valve replacement (V group), and sixteen received congenital heart surgery(C group).Triiodothyronine(T 3),thyroxine(T 4),free triiodothyronine (FT 3), free thyroxine (FT 4) and thyroid stimulating hormone (TSH) were measured by radioimmunoassay before and after anesthesia induction, and after operation. Results:After surgery, T 3 and FT 3 in two groups declined significantly. T3 and FT 3 in V group were significantly lower than those in C group pre and postoperatively. In V group, T 3 in patients with cardiac function NYHA Ⅳ was significantly lower than that in patients with NYHA Ⅱ～Ⅲ before and after surgery. Conclusion:T 3 as an inotropic agent after heart surgery is recommended for patients with severe cardiac dysfunction before operation.更多还原