初诊Graves 病患者治疗前后血清氨基末端 脑钠肽前体的水平变化

Change of NT-proBNP concentration before and after treatment in patients with newly-diagnosed Graves disease

摘要:

目的 通过观察初诊弥漫性甲状腺肿伴甲状腺功能亢进症（GD）患者治疗前后血清氨基末端 脑钠肽前体（NT-proBNP）水平的前后变化，探讨甲状腺功能、静息心率与血清NT-proBNP 水平的相关 性。方法 入选67 例不伴有明显心功能不全的初诊GD 患者，测定其治疗前及治疗后恢复至正常甲状腺功能 状态时的NT-proBNP 水平，同时测定20 例甲状腺功能正常健康志愿者的NT-proBNP 作为对照。结果 初 诊GD 患者治疗前的NT-proBNP 浓度较对照组高（P <0.05），经治疗达到正常甲状腺功能状态后，与对照 组比较差异无统计学意义（P >0.05）；NT-proBNP 较治疗前下降，NT-proBNP 的降低与游离三碘甲腺原氨 酸（FT3）、游离甲状腺素（FT4）的降低呈正相关（P <0.05），与促甲状腺激素（TSH）、静息心率（RHR） 的变化值无相关。结论 血清NT-proBNP 浓度受甲状腺功能状态的影响，甲状腺功能亢进状态可导致NTproBNP 假性升高。

Abstract:

Objective To observe the change of serum N-terminal pro-brain natriuretic peptide (NT-proBNP) concentration before and after treatment in patients with newly-diagnosed Graves disease (GD) complicated with hyperthyroidism and to explore the relationships of thyroid function and resting heart rate (RHR) with NT-proBNP concentration. Methods Sixty-seven newly-diagnosed GD patients without cardiac dysfunction were enrolled. Serum concentration of NT-proBNP was measured before treatment and when thyroid function returned to normal after treatment, while NT-proBNP concentration of 20 health persons with euthyroidism was measured as normal control. Results NT-proBNP concentration in the GD patients was higher than that in the normal controls before treatment (P < 0.05). When euthyroidism was achieved after treatment, NT-proBNP in the GD patients decreased and there was no difference between the GD patients and the normal controls (P > 0.05 ). The decrease in NT-proBNP was positively correlated with the decrease in FT3 and FT4 (P < 0.05), but not correlated with the change in TSH level or RHR. Conclusions The concentration of NT-proBNP is affected by the status of thyroid function, hyperthyroidism may cause high NT-proBNP measurement.