摘要
Abstract
Objective To investigate the effects of preoperative supplement of thyroxine on the thyroid hormone level and heart function during the perioperative period in rheumatic heart disease (RHD) patients underwent mitral valve replacement. Methods Total 36 RHD patients underwent mitral valve replacement under extracorporeal circulation were randomly divided into control group and experimental group. The experimental group were given thyroxine tablets with dose of 0.5 mg/ kg daily for 7 days postoperation. The serum levels of T3 ,FT3 ,T4,FT4 and TSH were measured at first day in hospital(t1), before anesthesia induction (t2 ) , before AAO liberalization (t3 ) , the first day postoperation (t4 ) ,4th day( t5 ) and 7th day (t6) .respectively. The serum levels of CK-MB and TnI were measured at 24h postoperation. The MAP,HR,CVP and the application of inotropic agent during the operation were also recorded. Results The levels of FT3 and T3 in both group at t1 were significantly lower than those at t2 (P < 0.05 ). The levels of T3, FT3, T3, FT4 at t1 in both groups were significantly lower than those at t2 after CPB ( P < 0.05 ). Compared with control group, the levels of FT3 and T3 in exprimental group significantly increased at t3 ,t4 and t5 ,and the levels of T4 was significantly increased at t2 and t3 ,and FT4 increased at t2. There was no significant difference in TSH level between two groups. Compared with control group,CK-MB content and TnI positive rate in exprimental group were significantly lower in experimental group(P <0.05). There was no significant deffer-ence in MAP.CVP and HR between two groups. From post CPB to the postoperative 4th day,the inetropic agent during the perioperative period in exprimental group was less than that in control group. Conclusion The preoperative supplement of thyroxine could relief the euthyroid sick syndrome (ESS) during perioperative period in RHD patients underwent mitral valve replacement,improve the heart function,decrease the dosage of inotropic agent and preserve myocardium.关键词
甲状腺激素/体外循环/风湿性心脏病/二尖瓣置换术Key words
Thyroxine/Extracorporeal circulation/Rheumatic heart disease/Replacement of mitral valve分类
医药卫生
