The Association Of Thyroid Hormone Level With Cardiac Function In Children With Pneumonia Merged Heart Failure

The current research have basically confirmed the existence of euthyroid sick syndrome?ESS?when CHF occurs.Most scholars believe that the change of thyroid hormone level can be used as an indicator to evaluate the CHF,about duration,severity,treatment effect and prognosis.But the data point to chronic heart failure in adults.The most commonplace in children is acute congestive heart failure which from pneumonia.This study was based on the changes of serum thyroid hormone level in patients with acute CHF,and provided a theoretical basis for the evaluation and early intervention of the severity of heart failure in children with pneumonia complicated with CHF.Objective:To explore the correlation between serum thyroid hormone levels and heart function in children with pneumonia complicated with heart failure.Methods:The research group included children with pneumonia who were hospitalized in Affiliated hospital of chengde medical university from September 2016 to February 2019,be divided into No heart failure group,Mild heart failure group,Moderate heart failure group and Severe heart failure group by the improved ROSS heart failure grading method.62 boys and 64 girls were included,with an average age of?5.2±2.4?months.During the same period,35 healthy infants who underwent physical examination in the outpatient department of our hospital were randomly selected as the control group,including 17 boys and 18 girls,aged 3-24.5 months,with an average age of?5.7±1.9?months.Healthy children and pneumonia in children with acute phase serum TH,N terminal brain natriuretic peptide?N-BNP?level,determination of echocardiographic left ventricular ejection fraction?EF?,FS,PAP,E/A,using t test,analysis of variance and correlation analysis and other statistical methods,to analysis the correlation of serum thyroid hormone level with cardiac function.Results:1.There was no significant in T₃ level between the control group,No heart failure group?simple pneumonia?and Mild heart failure group?F=0.193,P=0.825>0.05?;Used LSD-t text to found it was statistically significant differences in T3 levels between different heart failure groups?Mild,Moderate,Severe??P<0.05?,T₃ level decreased gradually with the severity of heart failure?r=-0.692,P<0.01?;There was no significant difference in T₄ and TSH between the groups by one-way ANOVA?F=1.000,P>0.05;F=0.450,P>0.05?.2.EF and FS were significantly different in Mild,Moderate and Severe heart failure groups?F=12.451,P<0.01;F=7.310,P<0.01?.EF decreased gradually with the aggravation of heart failure?r=-0.433,P<0.05?,while lg?N-BNP?increased with the aggravation of heart failure?r=0.734,P<0.05?.There was no significant difference between the groups of PAP and E/A?F=0.987,P>0.05;F=0.181,P>0.05?.3.On the basis of two-variable correlation analysis,T₃ value has a positive correlation with EF on the whole??=0.687,P<0.01?,and T₃ has a negative correlation with lg?N-BNP?on the whole??=-0.337,P<0.01?.Conclusion:Pneumonia in children with HF,as the degree of cardiac insufficiency is aggravating,the level of N-BNP increased,LVEF decreased,and serum T₃ level decreased.It is suggested that euthyroid sick syndrom?ESS?also occur in children with acute congestive heart failure?CHF?,and the lower the T₃ level,the severer the degree of cardiac insufficiency.