游离三碘甲状腺原氨酸水平与稳定性冠心病患者冠状动脉斑块易损性及多支病变的关系  

Correlation between Free Triiodothyronine Levels and Coronary Atherosclerotic Plaque Vulnerability and Multibranch Lesions in Patients with Stable Coronary Artery Disease

作　　者：巩杨超 刘成峰 王西强 刘仲伟[3] 姜馨[3] GONG Yangchao;LIU Chengfeng;WANG Xiqiang;LIU Zhongwei;JIANG Xin(Xi'an Medical University,Xi'an 710068,China;Yan'an University,Yan'an 716000,China;Cardiovascular Internal Medicine,Shaanxi Provincial People's Hospital,Xi'an 710068,China)

机构地区：[1]西安医学院,陕西省西安市710068 [2]延安大学,陕西省延安市716000 [3]陕西省人民医院心血管内科,陕西省西安市710068

出　　处：《实用心脑肺血管病杂志》2023年第4期26-30,共5页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

基　　金：陕西省重点研发计划项目(2019ZDLSF01-01-01)。

摘　　要：目的探讨游离三碘甲状腺原氨酸(FT_(3))水平与稳定性冠心病(SCAD)患者冠状动脉斑块易损性及多支病变的关系。方法选取2021年11月至2022年6月于陕西省人民医院心血管内科住院治疗的SCAD患者86例为研究对象。收集患者的临床资料,采用血管内超声(IVUS)测量脂质池面积、纤维帽厚度、外弹力膜(EEM)面积、斑块面积、斑块负荷、斑块长度,根据冠状动脉造影(CAG)检查结果将冠状动脉病变分为单支病变和多支病变。FT_(3)水平与脂质池面积的相关性分析采用Pearson相关分析;SCAD患者发生多支病变的影响因素分析采用单因素、多因素Logistic回归分析;采用ROC曲线分析FT_(3)水平对SCAD患者发生多支病变的评估价值。结果86例SCAD患者的FT_(3)水平为2.68~6.05 pmol/L,中位数为4.54 pmol/L,根据FT_(3)水平中位数将患者分为低FT_(3)组(FT_(3)≤4.54 pmol/L,n=43)和高FT_(3)组(FT_(3)>4.54 pmol/L,n=43)。两组脂质池面积、多支病变发生率比较,差异有统计学意义(P<0.05)。Pearson相关分析结果显示,SCAD患者FT_(3)水平与脂质池面积呈负相关(r=-0.707,P<0.001)。多因素Logistic回归分析结果显示,FT_(3)水平、斑块长度是SCAD患者发生多支病变的独立影响因素(P<0.05)。ROC曲线分析结果显示,FT_(3)水平评估SCAD患者发生多支病变的曲线下面积为0.720〔95%CI(0.611,0.829),P<0.001〕,Youden指数最大值为0.359,最佳截断值为4.65 pmol/L,灵敏度为71.2%,特异度为64.7%。结论FT_(3)水平与SCAD患者冠状动脉斑块易损性呈负相关,FT_(3)水平是SCAD患者发生多支病变的独立影响因素,且对其具有中等评估价值。Objective To investigate the correlation between free triiodothyronine(FT_(3))levels and coronary atherosclerotic plaque vulnerability and multi-branch lesions in patients with stable coronary artery disease(SCAD).Methods A total of 86 patients with SCAD who were hospitalized in the Cardiovascular Internal Medicine of Shaanxi Provincial People's Hospital from November 2021 to June 2022 were selected as the research subjects.The clinical data of the patients were collected,the lipid pool area,plaque fibrous cap thickness,external elastic membrane(EEM)area,plaque area,plaque load and plaque length were measured by intravascular ultrasound(IVUS).Coronary artery lesions were divided into single-vessel lesion and multi-branch lesions according to the coronary angiography(CAG)results.Pearson correlation analysis was used to analyze the correlation between FT_(3) level and lipid pool area.Univariate and multivariate Logistic regression analysis was used to explore the influencing factors of multi-branch lesions in patients with SCAD.ROC curve was used to analysis the value of FT_(3) level in evaluating multi-branch lesions in patients with SCAD.Results FT_(3) levels of 86 SCAD patients ranged from 2.68 to 6.05 pmol/L,with a median of 4.54 pmol/L.Patients were divided into low FT_(3) group(FT_(3)≤4.54 pmol/L,n=43)and high FT_(3) group(FT_(3)>4.54 pmol/L,n=43)according to the median FT_(3) level.There was statistically significant differences in the lipid pool area and the incidence of multi-branch lesions between the two groups(P<0.05).The results of Pearson correlation analysis showed that FT_(3) level was negatively correlated with lipid pool area in SCAD patients(r=-0.707,P<0.001).Multivariate Logistic regression analysis showed that FT_(3) level and plaque length were the independent influencing factors of multi-branch lesions in patients with SCAD(P<0.05).ROC curve analysis showed that the area under the curve of FT_(3) level in evaluating multi-branch lesions in patients with SCAD was 0.720[95%CI(0.611,0.829),P<0

关 键 词：冠心病 游离三碘甲状腺原氨酸 斑块易损性 多支病变 

分 类 号：R541.4[医药卫生—心血管疾病]