云南地区慢性心力衰竭患者正常甲状腺功能病态综合征的流行病学调查  

Prevalence of euthyroid sick syndrome in patients with heart failure in Yunnan Province

作　　者：王芳芳 陈章荣 吴新华 杨云贵[2] 董瑜 杨瑛 刘宏 张健[3] 

机构地区：[1]大理大学附属医院心内科,云南大理671000 [2]云南省曲靖市第一人民医院干疗科,云南曲靖655000 [3]中国医学科学院阜外心血管病医院心力衰竭中心,北京100037

出　　处：《中国现代医学杂志》2017年第15期78-81,共4页China Journal of Modern Medicine

基　　金："十二五"国家科技支撑计划重大项目(No:2011BA111B02);国家自然科学基金(No:81560073)

摘　　要：目的了解云南地区慢性心力衰竭(CHF)患者正常甲状腺功能病态综合征(ESS)的流行病学特点,为该地区CHF合并ESS提供科学防治。方法选取2 560例CHF患者临床资料,剔除缺失数据共1 083例患者,分析CHF患者ESS发生率的变化情况。结果 CHF患者ESS发生率为25.4%,心功能Ⅱ级患者ESS发生率为11.6%,心功能Ⅲ级为19.6%,心功能Ⅳ级为43.7%,比较差异有统计学意义(P<0.05)。与射血分数保留的心力衰竭(HFp EF)组心力衰竭患者比较,射血分数下降的心衰(HFr EF)组ESS发生率更高(P<0.05)。随着年龄阶段的增长,ESS发生率越高,差异有统计学意义(P<0.05)。CHF患者中,男性ESS发生率为26.5%,女性ESS发生率为24.6%,差异无统计学意义(P>0.05)。不同疾病所致CHF的ESS发生率各不相同,差异无统计学意义(P>0.05)。CHF患者的年龄、心功能、BNP和LVEDD值是ESS发生率的危险因素(P<0.05),而LVEF值是ESS发生率的保护因素(P<0.01)。结论 CHF患者合并ESS发病率较高,其与年龄、心功能、LVEF及LVEDD有关,随着心功能越差,年龄越高,LVEF越低,LVEDD越大,ESS发生率越高。Objective To explore the prevalence of euthyroid sick syndrome （ESS） in patients with chronic heart failure （CHF） in Yunnan Province. Methods The clinical data of 2,560 patients with CHF were collected and the patients who missed thyroid hormone （TH） were excluded. Finally, total 1,083 patients participated in this study. According to age, cardiac function of NYHA class and etiology, the prevalence of ESS in patients with CHF was investigated. Results ESS prevalence was 25.4% in patients with CHF, ESS prevalence of NYHA class Ⅱ, NYHA class Ⅲ, NYHA class Ⅳ were 11.6%, 19.6% and 43.7% respectively. The difference of ESS prevalence of these groups had statistical significance （ 〈0.05）. ESS prevalence of HFREF group was higher than that in HFPEF group （ 〈 0.05）. ESS prevalence was increased with age growth, the difference had statistically significant （ 〈0.05）. ESS prevalence in female and male patients were 24.6%, 26.5% respectively.The difference of ESS prevalence of these groups had no statistical significance （ 〉0.05）. The difference of different etiology was not statistically significant （ 〉0.05）. Age, cardiac function, etiology, BNP, LVEDD of CHF patients wew risk factors for the incidence of ESS （ 〈0.05）, and LVEF was the protective factors （ 〈0.05）. Conclusions The prevalence of ESS in patients with CHF are high in Yunnan Province, and the prevalence inceases with age growth, LVEDD increasing, LVEF decreasing, cardiac function worsening.

关 键 词：慢性心力衰竭 正常甲状腺病态综合征 流行病学调查 

分 类 号：R581[医药卫生—内分泌]