甲状腺激素抵抗与冠状动脉粥样硬化的关系  

Relationship between Thyroid Hormone Resistance and Coronary Atherosclerosis

作　　者：孙蔚雯 牛永红 SUN Yuwen;NIU Yonghong(Department of Cardiology,The First Affiliated Hospital of Tsinghua University,Beijing 100016,China)

机构地区：[1]清华大学第一附属医院心脏中心,北京100016

出　　处：《岭南心血管病杂志》2025年第1期40-44,共5页South China Journal of Cardiovascular Diseases

摘　　要：目的研究甲状腺功能正常人群的甲状腺激素抵抗与冠状动脉粥样硬化的相关性。方法选取2020年1月至2020年12月在清华大学第一附属医院心脏中心住院的甲状腺功能正常并行冠状动脉造影检查的患者405例为研究对象。检测所有受试者的甲状腺激素(thyroid hormone,TH)、血脂等指标,计算甲状腺功能参数:促甲状腺激素指数(thyrotropin index,TSHI)、促甲状腺激素抵抗指数(thyrotroph T4 resistance index,TT4RI)、参数化甲状腺反馈分位数指数(parametric thyroid feedback quantile-based index,PTFQI)、游离甲状腺素(free thyroxine,FT4)/游离三碘甲状腺原氨酸(free triiodothyronine,FT3)和外周5′-脱碘酶活性总(sum activity of peripheral deio⁃dinases,SPINA-GD)。研究对象完善冠状动脉造影检查,并行Gensini评分。根据Gensini评分将入组对象分为低值组(0分≤Gensini评分<10分)、中间组(10分≤Gensini评分<30分)和高值组(Gensini评分≥30分),探究甲状腺功能参数与冠状动脉粥样硬化的相关性。结果3组对象男性患者比例、年龄、吸烟患者比例、糖化血红蛋白随Gensini评分增加而增加,高密度脂蛋白胆固醇(HDL-C)随Gensini评分增加而降低,差异有统计学意义(P<0.05)。甲状腺功能参数:FT3、FT3/FT4、TSHI、TT4RI、PTFQI、SPINA-GD随Gensini评分增高而降低,差异有统计学意义(P<0.05)。Gensini评分与FT3、FT3/FT4、TSHI、TT4RI、PTFQI、SPINA-GD呈负相关(P<0.05)。FT3与TSHI、TT4RI、PTFQI呈正相关(P<0.05)。结论甲状腺功能正常人群中,甲状腺激素外周性抵抗可能与冠状动脉粥样硬化相关,FT3浓度可能与冠状动脉粥样硬化程度成负相关。Objectives To study the correlation between thyroid hormone resistance and coronary atherosclerosis in euthyroid function population.Methods A total of 405 euthyroid function patients who were hospitalized in The First Affiliated Hospital of Tsinghua University from January 2020 to December 2020 were selected.Thyroid function,lipid and other indicators were collected,and thyroid function parameters were calculated:thyrotropin index(TSHI),thyrotroph T4 resistance index(TT4RI),parametric thyroid feedback quantile-based index(PTFQI),free thyroxine(FT4)/free triiodothyronine(FT3),and the sum activity of peripheral deiodinases(SPINA-GD).The subjects underwent coronary angiography and their Gensini score were calculated.According to the Gensini score,the enrolled subjects were catego⁃rized into low-value group(0≤Gensini score<10 scores),middle value group(10 scores≤Gensini score<30 scores),and high-value group(Gensini score≥30 scores),to explore the correlations between thyroid function parameters and coronary atherosclerosis.Results The proportion of male and smokers,age and concentration of glycosylated hemoglobin increased with the increase of Gensini score,concentration of high-density lipoprotein-cholesterol(HDL-C)reduced with the increase of Gensini score(P<0.05).In terms of thyroid function parameters,FT3,FT3/FT4,TSHI,TT4RI,PTFQI and SPINA-GD decreased with the increase of Gensini score(P<0.05).Gensini score was negatively correlated with FT3,FT3/FT4,TSHI,TT4RI,PTFQI,and SPINA-GD(P<0.05).FT3 was positively correlated with TSHI,TT4RI,PTFQI(P<0.05).Conclusions In euthyroid function population,peripheral thyroid hormone resistance aggra⁃vated coronary atherosclerosis,concentration of FT3 is negatively correlated with the degree of coronary atherosclerosis.

关 键 词：冠状动脉疾病 甲状腺功能参数 甲状腺激素抵抗 

分 类 号：R544.1[医药卫生—心血管疾病]