临床甲亢患者左心室舒张功能障碍影响因素分析  

Influencing factors of left ventricular diastolic dysfunction in patients with hyperthyroidism

作　　者：谢治丽[1] 武丽丽[1] 陈晓晴[1] 徐成润[1] XIE Zhi-li;WU Li-li;CHEN Xiao-qing;XU Cheng-run(Department of Cardiovascular,No.909 Hospital,Joint Logistics Support Force of PLA,Dongnan Hospital of Xiamen University,School of Medicine,Xiamen University,363000 Zhangzhou,China)

机构地区：[1]联勤保障部队第九〇九医院,厦门大学附属东南医院心血管内科,福建省漳州市363000

出　　处：《中国心血管病研究》2022年第2期118-122,共5页Chinese Journal of Cardiovascular Research

基　　金：福建省医学创新课题项目(2018-CX-42)。

摘　　要：目的分析临床甲状腺功能亢进(甲亢)患者左心室(left ventricular,LV)舒张功能障碍的危险因素。方法回顾性分析2015年1月至2020年12月期间联勤保障部队第九○九医院收治的466例甲亢患者临床资料。使用多普勒超声心动图评估LV舒张功能,并根据有无左心室(LV)舒张功能障碍分为研究组(有舒张功能障碍)和对照组(无舒张功能障碍)。根据中国人群的体重指数(body mass index,BMI)标准将全部患者分为:体重过低组(<18.5 kg/m^(2))、体重正常组(18.5~23.9 kg/m^(2))、超重(24.0~27.9 kg/m^(2))和肥胖(≥28.0 kg/m^(2))组。由于超重样本量相对较小,将超重和肥胖合并为一组。根据患者年龄不同,分为<40岁组,40~50组,50~60组和≥60组。比较研究组和对照组患者临床资料差异,logistic回归分析影响患者LV舒张功能障碍的危险因素。结果全部甲亢患者中LV舒张功能障碍164例,发病率为35.19%。临床甲亢患者发病率随着年龄和BMI的增加而增加。与对照组相比,研究组患者的超声心动图参数中的左心房直径、室间隔厚度和二尖瓣口前向血流频谱A峰升高(均P<0.05);二尖瓣口前向血流频谱E峰和E峰/A峰比值显著降低(均P<0.001)。Logistic回归显示与正常BMI相比,超重/肥胖与LV舒张功能障碍显著相关(OR=3.103,P=0.001)。与<40岁组相比,40~50岁组(OR=2.969,P<0.001)、50-60岁组(OR=12.388,P<0.001)和年龄≥60岁组(OR=24.861,P<0.001)与LV舒张功能障碍显著相关(P均<0.05)。结论甲亢患者年龄和BMI是发生LV舒张功能障碍的独立危险因素。Objective To analyze the risk factors of left ventricular(LV) diastolic dysfunction in patients with hyperthyroidism. Methods The clinical data of 466 patients with hyperthyroidism treated in 909 th Hospital of the Joint Logistics Support Force from January 2015 to December 2020 were analyzed retrospectively. LV diastolic function was assessed by Doppler echocardiography and divided into study group(with diastolic dysfunction) and control group(without diastolic dysfunction). According to the body mass index(BMI) standard of Chinese population, all patients were divided into underweight group(<18.5 kg/m^(2)), normal weight group(18.5~23.9 kg/m^(2)), overweight group(24.0~27.9 kg/m^(2)) and obesity group(≥28.0 kg/m^(2)). Due to the relatively small sample size of overweight, the overweight group and the obesity group were combined into a group. According to the age of patients, they were divided into <40 years old group, 40~50 group, 50~60 group and ≥60 group. The differences of clinical data between the study group and the control group were compared and the risk factors of LV diastolic dysfunction were analyzed by logistic regression. Results LV diastolic dysfunction was found in 164 patients, with a 35.19% incidence rate. The incidence rate of hyperthyroidism increased with age and BMI.Compared with the control group, the left atrial diameter, ventricular septal thickness and the A peak of mitral valve anterior flow spectrum in the study group increased(all P<0.05);the E peak and E peak/A peak ratio of mitral valve anterior flow spectrum decreased significantly(all P<0.001). Logistic regression showed that overweight/obesity was significantly associated with LV diastolic dysfunction compared with normal BMI(OR=3.103, P=0.001). Compared with the <40 years old group, the 40~50 years old group(OR=2.969, P<0.001), the 50-60 years old group(OR=12.388, P<0.001) and the age ≥60 years old group(OR=24.861, P<0.001) were significantly correlated with LV diastolic dysfunction(all P<0.05). Conclusion The age and BMI

关 键 词：甲状腺功能亢进症 心功能 舒张功能障碍 超声心动图 

分 类 号：R445.1[医药卫生—影像医学与核医学]