摘要
目的 探讨甲状腺功能异常与冠状动脉粥样硬化性心脏病的关系.方法 选取北京协和医院2003年1月至2010年2月期间经冠状动脉造影证实有冠心病的2012例患者,通过甲状腺功能检查分为甲状腺功能正常组、甲状腺功能亢进组和甲状腺功能减退组,比较3组间危险因素和冠状动脉造影结果差异.结果 甲状腺功能亢进患者高血压、高血脂、糖尿病的患病率低于甲状腺功能正常及甲状腺功能减退患者（高血压：40%与69.4%与7 8.6%,Х^2=4.061,P=0.01;高血脂：20.0%与67.4%与85.7%,Х^2=12.331,P=0.002;糖尿病：20.0%与41.6%与35.7%,Х^2=2.114,P=0.347）;冠脉造影证实甲状腺功能减退患者的冠心病发生率（71.0%）高于甲状腺功能亢进患者（55.2%）,但差异无统计学意义（Х^2=1.804,P=0.179）;2例甲状腺功能亢进患者出现冠状动脉痉挛并发生急性心肌梗死.结论 甲状腺功能减退相比甲状腺功能亢进增加冠心病发病率;甲状腺激素水平的升高可能增加了冠脉痉挛和急性心梗的发生概率,但药物治疗后预后良好.
Objective To study the relationship between the thyroid dysfunction and coronary artery disease （CAD）. Methods Two thousands and twelve patients,diagnosed as CAD by coronary angiography from January 2003 to February 2010 in Peking Union Hospital,were enrolled into this study and divided into normal thyroid function, hyperthyroidism, and hypothyroidism groups. The thyroid function data and the coronary angiography findings were compared among three groups. Results The incidence rates of hypertension （40%vs. 69. 4% vs. 78.6%, Х^2 = 12. 331, P = 0. 01） and hyperlipemia（20. 0% vs. 67.4% vs. 85.7%, Х^2 =12. 331 ,P=0. 002） in hyperthyroidism patients were significantly lower than normal thyroid function patients and hypothyroidism patients, but no significant differences were found in the comparison of diabetes incidence rates among three groups （20. 0% vs. 41.6% vs. 35.7%, Х^2 = 2. 114,P =0. 347）. According to the coronary angiography findings, we found that the incidence rate of CAD of hypothyroidism patients was higher than hyperthyroidism patients（71.0% vs. 55. 2%, Х^2. = 1. 804, P = 0. 179）, but the difference didn＇ t reach statistically significant level. Two hyperthyroidism patients had coronary artery spasm and acute myocardial infarction. Conclusion Hypothyroidism had more promotion effect on coronary artery disease than hyperthyroidism,but higher serum thyroxin level increased the risk of coronary spasm and the probability of acute myocardial infarction,which could be well adjusted by medication treatment.
出处
《中国综合临床》
2011年第4期390-393,共4页
Clinical Medicine of China
