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目的：探讨心脏不停跳心内直视术甲状腺功能改变及意义。方法：用放射免疫分析法测定２７例心脏不停跳心内直视术的成人及儿童先心病患者术前、术中及术后甲状腺功能的改变。结果：①儿童组及成人组术中及术后血清ＴＴ３、ＦＴ３、ＴＴ４、ＦＴ４浓度低于术前，ｒＴ３明显增高，ＴＳＨ不升；②儿童组血清ＴＴ４、ＦＴ４最低值出现早于成人组；③预后不良患者血清ＴＴ３、ＴＴ４明显低于均值。结论：①心脏不停跳心内直视术治疗的先心患者术后出现“正常甲状腺病态综合征”；②根据激素的变化水平可预测患者预后；③甲状腺激素替代疗法可能有益于心肌保护。
Objective: To investigate the changes and significance of thyroid function in open heart surgery with beating heart. Methods: Radioimmunoassay was used to determine the changes of thyroid function before, during and after surgery in 27 adults with CHD undergoing open heart surgery. Results: ① The serum levels of TT3, FT3, TT4 and FT4 in children and adults after operation were lower than preoperatively and rT3 was significantly increased but TSH did not increase. ② The lowest serum TT4 and FT4 levels in children and adults were earlier than those in adults. ③ poor prognosis serum TT3, TT4 was significantly lower than the mean. Conclusions: ①The patients with congenital heart disease undergoing heart surgery undergoing open heart surgery have “normal thyroid syndrome”; ② The prognosis of patients can be predicted according to the changes of hormones; ③ Thyroid hormone replacement therapy may be beneficial to myocardial protection.