Japanese
Title虚血性心疾患発症初期および慢性心不全増悪期における血中TSH濃度
Subtitle原著
Authors川原林千津子*, 西大條靖子**, 西村恒彦*,***
Authors(kana)
Organization*国立循環器病センター放射線診療部, **内科, ***現;大阪大学医学部トレーサ情報解析
Journal核医学
Volume31
Number12
Page1443-1451
Year/Month1994/12
Article原著
Publisher日本核医学会
Abstract「要旨」ischemic heart disease (IHD) 発症後4日以内を「発症初期」およびcongestive heart failure (CHF) の増悪による緊急入院後4日以内を「CHF増悪期」と定め, この時期の血中thyroid stimulating hormone (TSH) 動態について検討した. TSH測定には, 高感度測定法である "IRMA法" を用いた. 対象はangina pectoris (AP) 群 (n=66, 平均62歳) acute myocardial infarction (AMI) 群 (n=58, 65歳) およびCHF群 (n=16, 68歳) であった. 各例のTSH値は正常または低値であった. CHF群でのTSH低値例 (低TSH例) 発生率 (31.3%) はAP群でのそれ (4.5%) に比し高率であった (p<0.05). AMI群において, 各例の血中TSH値は血中CPK max (入院後の経時的変化の中での最大CPK) と負に相関した. また, 低TSH群でのCPK max 5037±1102 U/l (Mean±SEM) は正常TSH群でのCPK max 1931±255 U/lに比し高値であった (p<0.05). 低TSH例は心筋壊死を伴い, 血行動態が悪化した病態 (CHF) にて最も高率にみられた. また, AMI群では, 血中TSH濃度は梗塞巣の拡がりの程度を表現し得ることが示唆された.
Practice臨床医学:一般
KeywordsThyroid stimulating hormone, Creatine phosphokinase, Ischemic heart disease, Congestive heart failure
English
TitleLow Serum TSH Levels in Patients with Emergent Conditions Due to Ischemic Heart Disease or Congestive Heart Failure
SubtitleOriginal Articles
AuthorsChizuko KAWARABAYASHI*, Yasuko NISHIOOEDA**, Tsunehiko NISHIMURA*
Authors(kana)
Organization*Department of Radiology, **Department of Internal Medicine, National Cardiovascular Center
JournalThe Japanese Journal of nuclear medicine
Volume31
Number12
Page1443-1451
Year/Month1994/12
ArticleOriginal article
PublisherTHE JAPANESE SOCIETY OF NUCLEAR MEDICINE
Abstract[Summary] We investigated the pathophysiological and clinical significance of thyroid stimulating hormone (TSH) levels in patients within 4 days after onset of ischemic heart disease (IHD) or aggravation of congestive heart failure (CHF) due to myocardial infarction. We classified patients into 3 groups : 1) angina pectoris (AP) group{n=66, 62 years (Mean)}, 2) acute myocardial infarction (AMI) group (n=58, 65 years) and 3) CHF group (n=16, 68 years). Soon after admission, blood samples were obtained to measure TSH by the IRMA method. Blood samples for creatine phosphokinase (CPK) were obtained every 3 hours. All patients showed TSH levels that were normal or below normal. Those in whom TSH levels were below normal, were defined as "low TSH" patients. The incidence of low TSH patients in the CHF group (31.3%) was significantly higher (p<0.05) than that in the AP group (4.5%). In the AMI group, plasma CPK activity of 5037+-1102 U/l (Mean+-SEM) in low TSH patients were significantly higher (p<0.05) than that of 1931+-255 U/l in patients with normal TSH levels. These results indicate that in patients with extensive myocardial cell damage, "low TSH" frequently develops during emergency.
PracticeClinical medicine
KeywordsThyroid stimulating hormone, Creatine phosphokinase, Ischemic heart disease, Congestive heart failure

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