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目的 观察儿童体外循环心脏手术前后甲状腺激素的变化，了解体外循环心脏手术对儿童甲状腺功能的影响并探讨其临床意义。方法 用放射免疫方法测定２５ 例体外循环心脏手术儿童术前、术中、术后甲状腺激素和促甲状腺激素的含量。结果 体外循环期间血浆三碘甲状腺原氨酸（ｔｒｉｉｏｄｏｔｈｙｒｏｎｉｎｅ，Ｔ３）、游离三碘甲状腺原氨酸（ｆｒｅｅ ｔｒｉｉｏｄｏｔｈｙｒｏｎｉｎｅ， ＦＴ３）、四碘甲状腺原氨酸（ｔｅｔｒａｉｏｄｏｔｈｙｒｏｎｉｎｅ， Ｔ４）、游离四碘甲状腺原氨酸（ｆｒｅｅｔｅｔｒａｉｏｄｏｔｈｙｒｏｎｉｎｅ， ＦＴ４） 均降低； 术后Ｔ３ 、ＦＴ３ 继续降低，Ｔ４ 、ＦＴ４ 恢复， 逆三碘甲状腺原氨酸（ｒｅｖｅｒｓｅｔｒｉｉｏｄｏｔｈｙｒｏｎｉｎｅ，ｒＴ３）明显升高，促甲状腺激素降低。结论 儿童体外循环手术对甲状腺功能有影响，术中、术后可出现低Ｔ３ 综合征，而低Ｔ３ 综合征对术后心功能可能产生不利影响。
Objective To observe the changes of thyroid hormones before and after cardiopulmonary bypass in children and to understand the effect of cardiopulmonary bypass surgery on thyroid function and to explore its clinical significance. Methods The levels of thyroid hormone and thyroid stimulating hormone in 25 children with cardiopulmonary bypass were measured by radioimmunoassay before operation, during operation and after operation. Results During plasma cardiopulmonary bypass, plasma levels of triiodothyronine (T3), free triiodothyronine (FT3), tetraiodothyronine (T4), free tetraethothyronine (FT4) were decreased in T3 and FT3 groups, while T3 and FT3 decreased, T4 and FT4 recovered, reverse triiodothyronine (rT3) increased significantly and thyroid-stimulating hormone decreased. Conclusion Children undergoing cardiopulmonary bypass surgery have an effect on thyroid function. There may be low T3 syndrome during and after operation, and low T3 syndrome may adversely affect cardiac function.