甲状腺功能与冠心病及其严重程度的相关性研究  

The correlation between thyroid function and the severity of coronary artery lesions

作　　者：于楠[1] 高莹[1] 龚艳君[2] 杨帆[2] 王智[2] 邱林[2] 康琦[1] 刘芳[1] 余洋[1] 郭晓蕙[1] 

机构地区：[1]北京大学第一医院内分泌科,北京100034 [2]北京大学第一医院心内科,北京100034

出　　处：《中国介入心脏病学杂志》2017年第12期671-676,共6页Chinese Journal of Interventional Cardiology

摘　　要：目的探讨甲状腺功能与冠心病及其严重程度的关系。方法回顾分析2013年1月至2015年6月在北京大学第一医院因疑诊冠心病进行冠状动脉造影检查并行甲状腺功能检测的患者558例,根据冠状动脉造影结果,分为冠心病组和非冠心病组,分析两组患者甲状腺功能状态,比较甲状腺激素水平和冠心病的关系;采集冠心病组患者的Syntax积分,分析其与甲状腺激素水平的相关性;依据促甲状腺素(TSH)水平进一步分层为升高组、正常组、减低组,分析其与冠心病病变的关系。结果本研究共纳入患者558例,男348例,女210例,平均年龄(62.7±10.9)岁。冠心病组409例(73.3%),平均年龄(63.3±11.0)岁。非冠心病组149例(26.7%),平均年龄(61.2±10.7)岁。两组患者的性别、年龄比较,差异无统计学意义。冠心病组低T3综合征患者比例明显高于非冠心病组(3.4%比1.3%,P=0.018),其他甲状腺功能异常状态两组比较,差异均无统计学意义(均P>0.05)。在非低T3综合征患者中分析,冠心病组游离三碘甲状腺原氨酸(FT3)水平低于非冠心病组[(4.52±0.57)pmol/L比(4.65±0.63)pmol/L,P=0.015]。两组患者游离四碘甲状腺原氨酸(FT4)、三碘甲状腺原氨酸(T3)、四碘甲状腺原氨酸(T4)、TSH水平比较,差异均无统计学意义(均P>0.05)。非低T3综合征的冠心病,395例患者中根据Syntax积分,低分组264例,中分组59例,高分组72例。FT3水平三组患者比较差异有统计学意义(F=6.260,P=0.002)而TT3、TT4、FT4、TSH水平,三组患者比较差异均无统计学意义。根据冠状动脉病变支数分组,单支病变组160例,双支病变组111例,三支病变组124例,FT3水平三组患者比较差异有统计学意义(F=5.691,P=0.004),TT3、TT4、FT4、TSH水平,三组患者比较差异均无统计学意义。所有患者均进行了TG、TCHO、HDL-C、LDL-C检测,经检验,所有患者的FT3、FT4、TT3、TT4、TSH水平与血脂各组份均未见显著相关性。按正常值范Obiective Tend to explore the correlation between thyroid function and the severity of coronary artery lesions in chinese coronary heart disease（CHD） patients. Methods A total of 558 patients who underwent coronary angiography at the cardiology department of Peking University First Hospital f rom January 2013 to June 2015 were enrolled in this retrospective study. All patients were divided into coronary heart disease group and non-coronary heart disease group. Thyroid hormone levels were tested in all patients before angiography, and clinical characteristics, lipid profiles and SYNTAX scores were also obtained. Results Of the 558 patients, 409 were diagnosed of CHD（73.3%）, and among them, 5 patients were hyperthyroid/subclinical hyperthyroid（1.2%）, 13 patients were hypothyroid/subclinical hypothyroid（3.2%）, 14 patients had euthyroid sickness syndrome（ESS）（3.2%）, 377 patients were euthyroid（92.2%）. Among the 149 non-CHD patients（26.7%）, 3 patients were subclinical hyperthyroid（2.0%）, 8 patients were hypothyroid/subclinical hypothyroid（5.4%）, 2 patients were ESS（1.3%）, 172 patients were euthyroid（91.3%）. The proportion of patients with ESS in the CHD group was significantly higher than that of the non-CHD group（3.4% vs. 1.3%, P=0.018）. Except for the patients with ESS, FT3 level was significantly lower the in CHD group than that in the non-CHD group[（4.52±0.57） pmol/L vs.（4.65±0.63） pmol/L, P=0.015]. There were no significant differences in FT4, T3, T4 levels between the two groups（P〉0.05）. In the CHD group, there was an association between the SYNTAX score groups and free triiodothyronine（FT3） levels（F=6.260,P=0.002）. A significant correlation was also observed between the FT3 level and the number of coronary artery lesions（F=5.691,P=0.004）. There was no correlation between the SYNTAX score groups or number of coronary artery lesions and thyroid hormone levels, respectively. There were no correlations between lipid profiles and thyroid

关 键 词：冠心病 甲状腺功能 三碘甲状腺原氨酸 

分 类 号：R541.4[医药卫生—心血管疾病] R581[医药卫生—内科学]