厦门地区老年冠心病合并不同程度甲减患者肾功能检测结果分析  

Analysis of different types of Hypothyroidism on Renal Function in elderly patients with coronary heart disease in Xiamen area

作　　者：葛高顺 林玲[2] 郑双林 范春明 蔡金特 谢华斌 GE Gao-shun;LIN Ling;ZHENG Shuang-lin(Department of Laboratory Medicine,Xiamen Cardiovascular Hospital of Xiamen University,School of Medicine,Xiamen University,Fujian Xiamen 361009)

机构地区：[1]厦门大学附属心血管病医院检验科,福建厦门361009 [2]厦门市中医院检验科,福建厦门361009

出　　处：《医学检验与临床》2022年第6期11-16,共6页Medical Laboratory Science and Clinics

基　　金：福建省医学创新课题(NO.2019-CXB-37)。

摘　　要：目的:探讨厦门地区老年冠心病合并不同程度甲减患者肾功能指标的差异。方法:选取厦门地区大于等于60岁到我院住院的冠心病患者,合并甲功正常100例、合并轻度亚甲减67例、合并重度亚甲减41例、合并甲减38例,检测游离T3(FT3)、游离T4(FT4)、促甲状腺激素(TSH)、甲状腺过氧化物酶抗体(TPOAb)、甲状腺球蛋白抗体(TGAb)、促甲状腺激素受体抗体(TRAb)、尿酸(UA)、尿素氮(UREA)、肌酐(CREA)、胱抑素C(CYSC)、肾小球滤过率(GFR)、内生肌酐清除率(Cct),分析各组上述指标的差异与相关性。结果;厦门地区老年冠心病合并甲减组女性比例最高,与合并甲功正常组比较,差异有统计学意义(P<0.05)。合并轻度亚甲减组Ccr水平较甲功正常组低,重度亚甲减组与甲减组GFR和Ccr水平较甲功正常组低、CYSC水平较甲功正常组高,差异具有统计学意义(P<0.05)。Spearman相关分析结果显示,FT3与Ccr呈正相关(r=0.47,P<0.01),TSH与Ccr呈负相关(r=0.38,P<0.01);UA、UREA、CREA、CYSC与TSH呈正相关(r=0.14,P=0.03)、(r=0.19,P<0.01)、(r=0.34,P<0.01)、(r=0.23,P<0.01),GFR与TSH呈负相关(r=0.37,P<0.01)。Logistic回归分析结果显示,年龄、吸烟和TSH是厦门地区老年冠心病患者Car偏低,肾功能损伤的危险因素(P<0.05)。结论:合并不同程度甲减对厦门地区老年冠心病患者肾功能有影响,Ccr为最敏感的指标。Objective:To investigate the difierence of renal function indexes in elderly patients with coronary heart disease complicated with difierent degrees of hypothyroidisni in Xiamen area.Methods:The experimental included 100 cases of normal thyroid function group,67 cases of mild subclinical hypothyroidisni(SCH)group,41 cases of severe subclinical hypothyroidism group,38 cases of hypothyroidism group in over 60 years old patients with coronary heart disease in our hospital.FT3,FT4,TSH,TPOAb,TGAb,TRAb,UA,UREA,CREA,CYSC,GFR and Ccr were detected.The difierences and the correlation between the difierent groups of these parameters were analysed.Results:The proportion of elderly women with coronary heart disease combined with hypothyroidism in Xiamen area was the highest,was difierent from the normal thyroid function group,it had statistical significance(P<0.05).The levels of Ccr in the mild subclinical hypothyroidism were lower than those in normal thyroidism group,the levels of GFR and Ccr in severe subclinical hypothyroidism group and hypothyroidism group were lower than those in normal thyroidism group,while the levels of Cysc were higher,it had statistical significance(P<0.05).Spearman correlation analysis showed that FT3 was positively correlated with Ccr(r=0.47,P<0.01),and TSH was negatively correlated with Ccr(r=-0.38,P<0.01).UA,UREA,CREA and CYSC were positively correlated with TSH(r=0.14,P=0.03),(r=0.19,P<0.01),(r=034,P<0.01)and(r=0.23,P<0.01),while GFR was negatively correlated with TSH(r=-0.37,0.01).Logistic regression analysis showed that age,smoking and TSH were risk factors for renal function injury(P<0.05).Con elusion:Combined with different degrees of hypothyroidism in elderly patients with coronary heart disease in Xiamen area has an impact on renal function,Ccr is the most sensitive index.

关 键 词：冠心病 甲减 亚临床甲减 肾功能 

分 类 号：R541.4[医药卫生—心血管疾病]