不同类型冠心病患者的甲状腺激素水平  

Thyroid hormone levels of patients with different types of coronary heart disease

作　　者：陈雪萍[1] 韦永强[1] 赵春丽[1] 

机构地区：[1]广西医科大学附属民族医院心内科,南宁市530000

出　　处：《广西医学》2018年第1期55-57,共3页Guangxi Medical Journal

摘　　要：目的比较不同类型冠心病患者的甲状腺激素水平。方法选择冠心病患者195例,分为急性心肌梗死(AMI)组(AMI组)122例及不稳定型心绞痛(UA)组(UA组)73例。AMI组根据经皮冠状动脉介入(PCI)的治疗时间分AMI急诊PCI组68例及AMI非急诊PCI组54例;AMI急诊PCI组又分为AMI非心力衰竭组40例及AMI心力衰竭组28例。选择同期经冠状动脉造影检查并排除冠心病的70例患者作为对照组。分别检测各组甲状腺激素水平。结果 AMI非急诊PCI组游离T_4(FT_4)、游离T_3(FT_3)水平及AMI急诊PCI组促甲状腺激素(TSH)、FT_3、FT_4均较对照组降低(P<0.05);AMI非急诊PCI组FT_3水平及AMI急诊PCI组TSH、FT_3、FT_4均较UA组降低(P<0.05)。AMI心力衰竭组血清FT_3水平低于AMI非心力衰竭组(P<0.05)。结论 AMI患者的甲状腺激素水平均呈不同程度改变,以TSH、FT_3、FT_4下降为主,其中FT_3降低可能与心功能受损程度有关。Objective To compare the thyroid hormone levels among patients with different types of coronary heart disease. Methods A total of 195 patients with coronary heart disease were divided into 122 cases in the acute myocardial infarction（ AMI） group（ AMI group）and 73 cases in the unstable angina（ UA） group（ UA group）. The AMI group was divided into AMI ＋ emergency percutaneous coronary intervention（ PCI） group（ n = 68） and AMI ＋ non emergency PCI group（ n = 54） according to the duration of PCI. The AMI ＋ emergency PCI group was divided into AMI ＋ non heart failure group（ n = 40） and AMI ＋ heart failure group（ n = 28）. A total of 70 patients without coronary heart disease,who were confirmed by coronary angiography,were selected as controls. The level of thyroid hormone was detected in each group.Results Compared to the control group,the levels of free thyroxine（ FT4） and free triiodothyronine（ FT3） in the AMI ＋ non emergency PCI group and the levels of thyroid stimulating hormone（ TSH）,FT3 and FT4 in the AMI ＋ emergency PCI group declined（ P〈 0. 05）. Compared to the UA group,the level of FT3 in the AMI ＋ non emergency PCI group and the levels of TSH,FT3 and FT4 in the AMI ＋ emergency PCI group decreased（ P〈 0. 05）. The level of serum FT3 in the AMI ＋ heart failure group was significantly lower than that in the AMI ＋ non heart failure group（ P〈 0. 05）. Conclusion The level of thyroid hormone shows changes in different degrees among patients with AMI,especially presenting the decline of TSH,FT3 and FT4. The decrease of FT3 may be related to the impairment of cardiac function.

关 键 词：冠心病 不稳定型心绞痛 急性心肌梗死 甲状腺激素 心力衰竭 

分 类 号：R541.4[医药卫生—心血管疾病]