摘要
目的探讨冠心病患者亚临床甲状腺功能减退症(SCH)与患者冠状动脉狭窄程度间的相关性。方法2018年3月至2019年9月浙江大学医学院附属邵逸夫医院和浙江省德清县人民医院行冠状动脉造影的患者中随机抽取138例,对其血清甲状腺素(FT4)、高敏促甲状腺激素(sTSH)进行测定,根据结果将其分为SCH组和正常组,并结合患者的冠状动脉造影结果对SCH与冠状动脉病变支数的相关性进行分析。结果SCH组患者的总胆固醇(TC)[(5.83±1.27)mmol/L和(5.02±1.22)mmol/L,t=3.746,P=0.000]、三酰甘油(TG)[(3.29±1.74)mmol/L和(2.17±1.68)mmol/L,t=3.769,P=0.000]、低密度脂蛋白胆固醇(LDL-C)[(3.81±1.02)mmol/L和(3.24±1.08)mmol/L,t=3.092,P=0.001]、高密度脂蛋白胆固醇(HDL-C)[(1.13±0.27)mmol/L和(1.02±0.25)mmol/L,t=2.4459,P=0.008]水平均明显高于正常组;以冠状动脉病变支数作为分组依据,三组患者的sTSH水平从高到低依次为多支病变组、双支病变组、单支病变组,(均P<0.05);以冠状动脉粥样硬化程度作为分组依据,三组患者的sTSH水平从高到低依次为重度组、中度组、轻度组(P<0.05);多元回归分析显示,SCH、TC、LDL-C均是影响患者冠状动脉病变支数的重要因素(均P<0.05)。结论SCH是引起冠心病患者冠状动脉狭窄程度发生和进展的重要因素,主要通过影响血脂代谢进而参与到冠心病患者的病情发展中。
Objective To investigate the correlation between subclinical hypothyroidism(SCH)and the degree of coronary artery stenosis in patients with coronary heart disease.Methods From March 2018 to September 2019,138 patients undergoing coronary angiography in our hospital were randomly selected and their serum thyroxine(FT4)and high-sensitivity thyroid stimulating hormone(sTSH)levels were measured.Based on the levels of FT4 and sTSH,patients were divided into the SCH group and the normal group.Combined with coronary angiography results,the correlation between the SCH and the number of coronary lesions were analyzed.Results Patients in the SCH group were associated with significantly higher levels of cholesterol(TC)[(5.83±1.27)mmol/L vs.(5.02±1.22)mmol/L,t=3.746,P=0.000],triglyceride(TG)[(3.29±1.74)mmol/L vs.(2.17±1.68)mmol/L,t=3.769,P=0.000],low-density lipoprotein cholesterol(LDL-C)[(3.81±1.02)mmol/L vs.(3.24±1.08)mmol/L,t=3.092,P=0.001],and high-density lipoprotein cholesterol(HDL-C)[(1.13±0.27)mmol/L vs.(1.02±0.25)mmol/L,t=2.4459,P=0.008]than those in the normal group.There were significant differences in sTSH levels between patients with multivessel,double vessel or single vessel disease when grouped by the number of coronary lesions,and between those with severe,moderate or mild coronary artery stenosis when grouped by disease severity(all P<0.05).Multiple regression analysis showed that SCH,TC,and LDL-C were factors affecting the number of coronary lesions(P<0.05).Conclusions SCH is an important factor that causes the occurrence and progression of coronary artery stenosis in patients with coronary heart disease,mainly by affecting lipid metabolism.
作者
黄芳芳
傅国胜
汤云霞
陈鑫芳
王友勇
Huang Fangfang;Fu Guosheng;Tang Yunxia;Chen Xinfang;Wang Youyong(Department of Cardiology,Sir Run Shaw Hospital,Zhejiang University School of Medicine,Hangzhou 310020 China;Department of Cardiology,Deqing County People's Hospital,Zhejiang Province,Huzhou 313200 China)
出处
《中华老年医学杂志》
CAS
CSCD
北大核心
2020年第5期505-508,共4页
Chinese Journal of Geriatrics
基金
2017年湖州市公益性应用研究项目。
