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目的:研究扩张型心肌病(DCM)不同心功能状态时甲状腺激素水平的变化.方法:选取DCM患者106例,NYHAⅡ级32例(Ⅱ级组),NYHAⅢ级48例(Ⅲ级组),NYHAⅣ级26例(Ⅳ级组).入院后完善生化检查和心脏超声.再根据患者血清游离三碘甲状腺原氨酸(FT3)水平四分位数进行分组,比较不同FT3组左室射血分数(LVEF)、高敏C反应蛋白(hsCRP)、氨基末端B型脑钠肽前体(NT-proBNP)的差别.结果:经单因素方差分析,NYHAⅡ级组、Ⅲ级组、Ⅳ级组之间NT proBNP、hsCRP的差异有统计学意义(P＜0.01);FT3和总三碘甲状腺原氨酸(TT3)之间差异亦有统计学意义(P＜0.01);而促甲状腺激素(TSH)、游离甲状腺素(FT4)、总甲状腺素(TT4)无统计学意义(P＞0.05).在以FT3四分位数进行分组中,FT3越低,LVEF就越低,而hsCRP和NT-proBNP越高.结论:DCM的FT3越低,则LVEF越低,同时hsCRP、NT-proBNP越高,预测患者的临床风险的增加.“,”Objective:To investigate the relationship between thyroid hormone levels and heart function in patients with dilated cardiomyopathy.Method:A total of 106 patients with dilated cardiomyopathy was enrolled in this study,including 32 patients in NYHA Ⅱ group,48 patients in NYHAⅢ group,26 patients in NYHA Ⅳ group.Laboratory and echocardiographic indicators were collected.Based on serum FT3 level,quartile subgroup were adopted.We analysis the left ventricular ejection fraction (LVEF),high sensitivity C-reactive protein (hsCRP),N-Terminal pro-brain natriuretic peptide precursor (NT-proBNP) in different FT3 subgroups.Result:Among the NYHAⅡ,Ⅲ and Ⅳ groups,NT-proBNP and hsCRP had significant differences(P＜0.01).FT3 and TT3 had significant differences(P＜0.01),while TSH,FT4,and TT4 didn\'t have any differences(P＞0.05).In the lower FT3 group,we would found the lower LVEF is lower,and the higher hsCRP and NT-proBNP is higher.Conclusion:Low FT3 usually associates with low LVEF or high hsCRP and NT-proBNP,which predicts high clinical risks in patients with dilated cardiomyopathy.