甲状腺激素与慢性心力衰竭衰患者心房颤动发生的相关分析  

Correlation between thyroid hormone and atrial fibrillation prevalence in patients with chronic heart failure

作　　者：孟军[1] 孙莉萍[1] 陈涛[1] 

机构地区：[1]三峡大学第三临床医学院葛洲坝中心医院心内科,湖北宜昌443002

出　　处：《岭南心血管病杂志》2017年第1期67-70,共4页South China Journal of Cardiovascular Diseases

摘　　要：目的分析甲状腺激素与慢性心力衰竭患者心房颤动发病率的相关性。方法选择2010年1月至2015年10月三峡大学第三临床医学院收治的非瓣膜性心脏病致慢性心力衰竭患者共348例,根据心电图检查及患者既往史分为窦性心律组155例和心房颤动组193例。住院后24 h内记录患者基本情况及病史,测定血清游离三碘甲状腺原氨酸(free triiodothyronine,FT3)、甲状腺素(free thyroxine,FT4)、低密度脂蛋白胆固醇(low density lipoprotein-cholesterol,LDL-C)、促甲状腺激素(hyroid stimulating hormone,TSH)浓度以及检测患者十二导联心电图和超声心动图,分析影响心力衰竭患者发生心房颤动的相关因素。结果心房颤动组血清FT4浓度显著增加,与窦性心律组比较差异有统计学意义(P<0.05);两组血清FT3浓度比较,差异无统计学意义(P>0.05)。Spearman秩相关性分析表明,血清FT4浓度与左心房内径(left atrial diameter,LAD)呈显著正相关(r=0.141,P=0.015),与TSH呈极显著负相关(r=-0.272,P<0.001);血清FT3浓度与患者年龄呈极显著负相关(r=-0.287,P<0.001),与血清LDL-C浓度呈极显著正相关(r=0.241,P<0.001);Logistic回归分析表明,年龄、心力衰竭持续时间、LAD、LDL-C、FT4对慢性心力衰竭患者心房颤动的发病率有影响(P<0.05)。结论血清FT4浓度的增高在一定程度上增加了慢性心力衰竭患者发生心房颤动的风险。Objectives To analyze the correlation between thyroid hormone and atrial fibrillation（AF）prevalence inpatients with chronic heart failure（CHF）.Methods Clinical data of 348 non-valvular heart disease CHF patientstreated in The Third Clinical Hospital of Shanxia University from January 2010 to October 2015 were retrospectivelyanalyzed.They were divided into 2 groups according to previous history and the electrocardiography（ECG）at admission：AF group（n=187）and sinus rhythm group（n=135）.Serum concentrations of free thyroxine（FT4）,free triiodothyronine（FT3）,hyroid stimulating hormone（TSH）and low density lipoprotein-cholestero（LDL-C）were examined within24 hours of admission.12 lead ECG and echocardiography were conducted to analyze the related factors of AF occurrence.Results Compared with that of sinus rhythm group,serum concentration of FT4 in AF group had obviously increased,and the difference was statistically significant（P〈0.05）.Serum concentration of FT3 between the two groups was notsignificantly different（P〈0.05）.Spearman related analysis indicated that serum concentration of FT4 positivelyrelated to left atrial diameter（LAD）（r=0.141,P=0.015）and negatively related to TSH（r=-0.272,P〈0.001）.Serumconcentration of FT3 positively related to LDL-C（r=0.241,P〈0.001）and negatively related to age（r=-0.287,P〈0.001）.Logistic regression analysis indicated that age,CHF duration,LAD,LDL-C and FT4 related to AFprevalence in CHF patients.Conclusions With serum concentration of FT4 increasing,to a certain extent,it increasesthe risk of AF prevalence in chronic heart failure patients.

关 键 词：心力衰竭 心房颤动 甲状腺激素 相关分析 

分 类 号：R541.6[医药卫生—心血管疾病] R541.7[医药卫生—内科学]