代谢综合征患者血清TSH水平与心肌重塑的相关性研究  

Correlation analysis of vent ventricular remodeling of serum TSH level in metabolic syndrome

作　　者：刘晓旭 薛凌 LIU Xiaoxu;XUE Ling(Department of Cardiology,the Third Affiliated Hospital of Jinzhou Medical University,Jinzhou,Liaoning 121000,China)

机构地区：[1]锦州医科大学附属第三医院全科,辽宁锦州121000

出　　处：《中国医学工程》2022年第10期34-41,共8页China Medical Engineering

摘　　要：目的本文旨在讨论代谢综合征(MetS)患者关于调节甲状腺激素分泌的血清促甲状腺激素水平与心肌重塑的相关性及其临床意义。方法选取于2020年6月至2021年5月就诊于锦州医科大学附属第三医院MetS患者共368例,按照血清促甲状腺素(TSH)水平分组,分为TSH低值组(A1组)130例和TSH高值组(A2组)85例、轻度亚临床甲减(B1组)94例和重度亚临床甲减(B2组)38例、TSH水平减低组(C组)21例。对比各临床指标之间的差异性,并分析MetS患者MetS各组分和TSH之间的相关性,MetS患者TSH水平变化与左心室质量及心室重塑之间的相关性及临床意义。结果对A、B、C三组一般资料进行统计学分析,三组之间性别、年龄、体质量指数(BMI)、腰围(WC)、收缩压(SBP)、空腹血糖(FPG)、甲状腺球蛋白(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、代谢综合征(MS)组分、颈动脉厚度(IMT)、Crouse积分、阻力指数(RI)、左心室舒张末期容积(LVEDV)、舒张末期室间隔厚度(IVST)、左心室质量(LVM)、左心室质量指数(LVMI)、相对室壁厚度(RWT)、左心室重塑指数(LVRI)差异性有统计学意义(P<0.05),DBP、2 hPG、HDL-C、血UA、血Hcy、T3、T4、既往糖尿病病史、糖尿病年限、既往高血压病史、高血压病年限、吸烟史、嗜酒史、LVDd、LAD、LVPWT、EF差异无统计学意义(P>0.05)。以LVMI、LVRI各自为因变量,将之前统计学分析得出A、B、C两组之间差异有统计学意义的各临床指标作为自变量,进行多重逐步线性回归,可认为是去除其他临床指标对因变量的影响后,LVMI与性别、TSH、SBP之间存在相关性。LVRI与TSH、性别、年龄、SBP之间存在相关性。TSH可作为MetS患者LVRI的独立危险因素。在控制性别影响因素下,用Spearman法直线相关性分析结果可得出TSH与LVM(r=0.493,P<0.05),LVMI(r=0.392,P<0.05),LVRI(r=0.565,P<0.05)均为正相关,与RWT(r=0.125,P>0.05)无相关性。结论MetS患者TSH水平【Objective】To discuss the correlation and its clinical value between serum TSH levels,which regulate thyroid hormone secretion,and vent ventricular remodeling in patients with MetS.【Methods】A total of 368 metabolic patients who met the inclusion criteria were enrolled in the Third Affiliated Hospital of Jinzhou Medical University from June 2020 to May 2021.The total cases were divided into three groups according to TSH level,including 130 cases of the low TSH group(group A 1)and 85 cases of the high TSH group(group A2),94 cases of the mild sub-clinical hypothyroidism(group B1)and 38 cases of the severe sub-clinical hypothyroidism(group B2),and 21 cases of the reduced TSH group(group C).The differences among the clinical indicators were compared.The correlation between the composition of MetS and TSH levels was analyzed.Correlation and clinical value between serum TSH level and left ventricular mass and ventricular remodeling in patients with MetS were analyzed.【Results】General clinical data of group A,B and C was analyzed,there were significant differences in gender,age,BMI,WC,SBP,FPG,TG,TC,LDL-C,MS component,IMT,Crouse score,RI,LVEDV,IVST,LVM,LVMI,RWT and LVRI among the three groups(P<0.05).There were no significant differences in DBP,2 hPG,HDL-C,UA,Hcy,T 3,T 4,history of diabetes,years of diabetes,history of hypertension,years of hypertension,history of smoking,alcohol consumption,LVDd,LAD,LVPWT and EF(P>0.05).LVDd,LAD,IVST,LVEDV,LVPWT,LVMI,RWT,LVRI and EF had no significant difference between group A and group C(P>0.05).These r esults showed that subclinical hyperthyroidism group(group C)had no significant effect on ventricular mass,remodeling and function.The results of Spearman linear correlation analysis showed that TSH and LVM(r=0.493,P<0.05),LVMI(r=0.392,P<0.05)and LVRI(r=0.565,P<0.05)were positively correlated.And RWT(r=0.125,P>0.05).【Conclusion】The levels of TSH in MetS patients were significantly increased,and there was a correlation between TSH and various components in MetS patients.U

关 键 词：代谢综合征 TSH 左心室质量 心室重塑 心脏功能 

分 类 号：R589[医药卫生—内分泌]