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目的研究先天性心脏病（以下简称先心）儿童围体外循环期血浆内皮素（ＥＴ）与甲状腺素（ＴＨＴ３、ＦＴ３、Ｔ４、ＦＴ４、γＴ３）的变化与相互关系。方法采用自身对照方法研究１４岁以下先心患儿围体外循环期（ＰＣＰＢ）ＥＴ与ＴＨ的变化。结果ＥＴ在体外循环（ＣＰＢ）中先降后升，术后１２ｈ达最高，２４ｈ仍明显高于术前（Ｐ＜００５）与术中（Ｐ＜００１），Ｔ３、Ｔ４的变化趋势同ＥＴ，但术后２４ｈ仍低于术前（Ｐ＜００５），γＴ３的变化趋势与Ｔ３、ＥＴ相反，Ｔ４、ＦＴ４的变化无显著性。相关分析表明ＥＴ与γＴ３在ＰＣＰＢ呈正相关（ｒ＝０８０，Ｐ＜００５），ＥＴ与Ｔ３、ＦＴ３、Ｔ４、ＦＴ４在此期无相关关系。结论先心儿童ＣＰＢ术后使用Ｔ３、内皮素拮抗剂或转换酶抑制剂在理论上是有根据的。
Objective To study the changes and correlations of plasma endothelin (ET) and thyroxine (THT3, FT3, T4, FT4, γT3) in children with congenital heart disease (hereinafter referred to as congenital heart disease) during peri-cardiopulmonary bypass. Methods To study the changes of ET and TH during peri-cardiopulmonary bypass (PCPB) in children under 14 years of age by self-control method. Results ET decreased first and then increased during cardiopulmonary bypass (CPB), reached the peak at 12 hours after operation, and remained significantly higher at 24h than before operation (P <005), intraoperative (P <001), T3 and T4 The trend was the same as that of ET, but it was still lower than preoperative 24h after operation (P <005). The trend of γT3 was opposite to that of T3 and ET. There was no significant change of T4 and FT4. Correlation analysis showed that there was a positive correlation between ET and γT3 in PCPB (r = 080, P <005). There was no correlation between ET and T3, FT3, T4 and FT4 in this period. Conclusions The use of T3, an endothelin antagonist or a switch enzyme inhibitor in children with congenital heart disease after CPB is theoretically justified.