心肌酶水平变化对甲状腺功能亢进性心脏病患者的诊断价值  

Diagnostic value of the changes in cardiac enzyme levels of patients with hyperthyroid heart disease

作　　者：李庞敏 刘立栋 王亚妮 毛培军 谢学健 LI Pangmin;LIU Lidong;WANG Yani;MAO Peijun;XIE Xuejian(Department of Endocrinology,the 986th Hospital of Air Force,Shaanxi,Xi'an 710054,China;Department of Cardiology,the 986th Hospital of Air Force,Shaanxi,Xi'an 710054,China)

机构地区：[1]空军第九八六医院内分泌科,陕西西安710054 [2]空军第九八六医院心血管内科,陕西西安710054

出　　处：《中国医药科学》2022年第14期146-149,156,共5页China Medicine And Pharmacy

摘　　要：目的分析甲状腺功能亢进性心脏病(HHD)患者心肌酶水平变化,评估其在HHD早期诊断的临床应用价值。方法收集2010年1月至2019年12月在空军第九八六医院诊断为甲状腺功能亢进(HT)患者226例,其中HHD患者76例为HHD组,心功能正常患者150例为HT组,收集患者的基本临床信息、心电图、心脏彩超、血清促甲状腺激素(TSH)、甲状腺激素(TH)、谷草转氨酶(AST)、乳酸脱氢酶(LDH)、α-羟丁酸脱氢酶(α-HBD)、肌酸激酶(CK)、肌酸激酶同工酶MB(CK-MB)等检查结果。结果HHD组患者血清FT_(3)及FT_(4)水平显著高于HT组,差异有统计学意义(P<0.05)。HHD组患者的CK-MB和α-HBD的水平显著高于HT组,差异有统计学意义(P<0.05);α-HBD、CK-MB两指标ROC曲线下面积分别为0.921、0.926,敏感度分别为77.8%、74.1%,特异度分别为96.3%、90.7%。结论对HT患者尤其病程较长的,应动态观察CK-MB、α-HBD水平变化,可较早筛出心脏受损患者。Objective To analyze the changes in cardiac enzyme levels of patients with hyperthyroid heart disease(HHD)and assess the clinical value of such changes in the early diagnosis of HHD.Methods A total of 226 patients with hyperthyroidism(HT)diagnosed in the 986th Hospital of Air Force from January 2010 to December 2019 were collected,including 76 patients with HHD in the HHD group and 150 patients with normal cardiac function in the HT group.The basic clinical information,electrocardiogram,echocardiography,serum thyroid stimulating hormone(TSH),thyroid hormone(TH),aspartate aminotransferase(AST),lactate dehydrogenase(LDH),andα-Hydroxybutyrate dehydrogenase(α-HBD),creatine kinase(CK),creatine kinase isoenzyme-MB(CK-MB)were collected.Results The serum free triiodothyronine(FT_(3))and free thyroxine(FT_(4))levels in the HHD group were significantly higher than those in the HT group,with statistically significant differences(P<0.05).The levels of CK-MB andα-HBD in the HHD group were significantly higher than those in the HT group,with statistically significant differences(P<0.05).The areas under the receiver operating characteristic(ROC)curves were 0.921 and 0.926,the sensitivity was 77.8%and 74.1%,and the specificity was 96.3%and 90.7%forα-HBD and CK-MB,respectively.Conclusion Dynamic observation of the changes in CK-MB andα-HBD levels of HT patients,especially in those with a long duration of disease should be strengthened,to screen out patients with heart damage earlier.

关 键 词：甲状腺功能亢进 甲状腺功能亢进性心脏病 血清心肌酶 ROC曲线 

分 类 号：R541.85[医药卫生—心血管疾病]