舒张性心力衰竭患者血清T3与LVEDP相关性及对预后的影响  

Association of serum triiodothyronine with left ventricular end diastolic pressure in diastolic heart failure patients and its prognosis

作　　者：刘畅[1] 鞠晨晖 高传玉[1] 王宪沛[1] 麻兴华 

机构地区：[1]郑州大学人民医院心内科,450052

出　　处：《中国心血管杂志》2016年第1期32-35,共4页Chinese Journal of Cardiovascular Medicine

基　　金：国家自然科学青年基金(U1204801)~~

摘　　要：目的探讨舒张性心力衰竭患者血清三碘甲状腺原氨酸(T3)水平与左室舒张末期压力(LVEDP)相关性及对2年预后的影响。方法连续入选2012年5月至2013年5月期间舒张性心力衰竭患者76例,行左室导管检查测LVEDP评估左心室舒张功能,根据T3水平的中位数分为高T3组(f T3≥4.32 pmol/L,39例)和低T3组(f T3<4.32 pmol/L,37例),比较两组间一般临床特征,分析T3与LVEDP的相关性,并随访记录2年的患者主要终点事件:各种原因导致的死亡及心力衰竭再住院率。结果舒张性心力衰竭患者T3低于正常值者为15%(11/76)。与高T3组相比,低T3组患者年龄较大,血脂较高,LVEDP水平偏高,且T3与LVEDP呈线性负相关,随访2年,与高T3组相比,低T3组患者2年死亡率显著升高[21.6%(8/37)比5.1%(2/39),P=0.043]。结论低T3舒张性心力衰竭患者心脏舒张功能差,且预后差。Objective To analyze the relationship of serum free triiodothyronine（ FT3） level with left ventricular end diastolic pressure（ LVEDP） and its prognosis in patients with diastolic heart failure. Methods From May 2012 to May 2013,76 patients with diastolic heart failure who underwent left ventricular catherization were selected. The patients were divided into 2 groups based on the median levels of T3,high T3 group（ T3≥4. 32 pmol / L,39 patients） and low T3 group（ T3 4. 32 pmol / L,37 patients）.We compare the clinical general characteristics,laboratory tests and ultrasonic auxiliary examination between the two groups,and analyze the correlation of T3 and LVEDP and its prognosis. The patients were followed up 2 years for endpoint events： death from all causes and heart failure readmission rates. Results T3 level lower than normal in diastolic heart failure patients was 15%（ 11 /76）. High T3 group were older and had higher cholesterol,LVEDP level,and T3 compared with that in low T3 group. T3 level was negatively correlated with LVEDP. Followed for 2 years,the mortality of low T3 group [21. 6%（ 8 /37） ] was significantly increased compared with high T3 group [5. 1%（ 2 /39） ],P = 0. 043. Conclusions Low T3 level patients with diastolic heart failure have poor cardiac function and worse prognosis.

关 键 词：心力衰竭 甲状腺疾病 左室舒张末期压力 

分 类 号：R541.6[医药卫生—心血管疾病]