摘要
目的探讨甲状腺功能正常的冠心病患者颈动脉内膜中层厚度(IMT)与血清促甲状腺激素(TSH)水平的关系。方法选取2012年7月—2013年7月在新疆医科大学第一附属医院住院的甲状腺功能正常的冠心病患者223例。以IMT参考值0.09 cm为标准将患者分为IMT正常组(IMT<0.09 cm)100例和IMT增厚组(IMT≥0.09 cm)123例;依据2002年美国国家临床生化学会(NACB)推荐分析TSH值,以患者血清TSH观察值的P25(TSH为1.35μU/ml)及P75(TSH为2.57μU/ml)为切点,将患者分为高TSH组(TSH≥2.57μU/ml)54例、中TSH组(1.35μU/ml<TSH<2.57μU/ml)109例及低TSH组(TSH≤1.35μU/ml)60例。收集患者一般临床资料〔身高、体质量,并计算体质指数(BMI)〕,测定三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、载脂蛋白A1、载脂蛋白B,测定IMT及血清TSH水平,分析IMT与血清TSH水平的相关性。结果IMT增厚组患者的年龄、BMI、TG、TC、LDL-C、载脂蛋白B、血清TSH水平均高于IMT正常组(P<0.05)。高TSH组、中TSH组、低TSH组的BMI、TG、TC、IMT比较,差异均有统计学意义(P<0.05)。高TSH组的BMI、TG、TC、IMT均高于中TSH组、低TSH组(P<0.05);中TSH组的TC高于低TSH组(P<0.05)。Pearson相关分析显示,IMT与年龄、BMI、TG、TC、LDL-C、载脂蛋白B、血清TSH水平呈正相关(r=0.245、0.258、0.476、0.335、0.218、0.115、0.346,P<0.05);采用偏相关分析校正年龄、BMI、TG、TC、LDL-C、载脂蛋白B后,IMT与血清TSH水平仍呈正相关(r=0.185,P<0.05)。多元线性回归分析显示,年龄、TG、血清TSH水平是影响IMT的独立危险因素(标准化偏回归系数分别为:0.170、0.240、0.377,P<0.05);进一步校正BMI、TC、LDL-C、载脂蛋白B后,年龄、TG、血清TSH水平仍是影响IMT的独立危险因素(标准化回归系数分别为:0.429、0.241、0.190,P<0.05)。结论甲状腺功能正常的冠心病患者的IMT与血清TSH水平呈正相关,血清TSH水平可能是�
Objective To explore the relationship between carotid artery intima-media thickness（IMT） and serum thyroid stimulating hormone（TSH） level in coronary artery disease（CHD） patients with normal thyroid function.Methods A total of 223 CHD patients with normal thyroid function hospitalized in the First Affiliated Hospital of Xinjiang Medical University from July 2012 to July 2013 were divided,taking IMT reference value 0.09 cm as standard,into groups normal IMT（IMT 0.09 cm,n=100）,thickening IMT（IMT≥0.09 cm,n=123）,and according to 2002 US NACB recommended analysis TSH value,taking serum TSH observed number percentile P25（TSH =1.35 μU/ml）,P75（TSH =2.57 μU/ml） as point of contact,into groups high TSH（TSH≥ 2.57 μU /ml,n=54）,moderate TSH（1.35 μU /mlTSH2.57 μU /ml,n=109）,low TSH（TSH ≤1.35 μU /ml,n=60）.Patients＇ general clinical data（body height,body mass,BMI） were collected,TG,TC,LDL-C,HDL-C,apolipoprotein A1,apolipoprotein B,serum TSH levels were measured,and the correlation between IMT and TSH level were analyzed.Results The age,BMI,TG,TC,LDL-C,apolipoprotein B,TSH were higher in thickening IMT group than in normal IMT group（P〈0.05）.There was significant difference in BMI,TG,TC,IMT between groups high,moderate,low TSH（P〈0.05）;BMI,TG,TC,IMT were higher in high TSH group than in groups moderate,low IMT（P〈0.05）,TC was higher in moderate group than in low TSH group（P〈0.05）.Pearson correlation analysis showed that IMT was positively correlated with age,BMI,TG,TC,LDL-C,apolipoprotein B,TSH（r=0.245,0.258,0.476,0.335,0.218,0.115,0.346,respectively,P〈0.05）;after partial correlation analysis adjusted age,BMI,TG,TC,LDL-C,apolipoprotein B,ITM was still positively correlated with TSH（r=0.185,P〈0.05）.Multiple linear regression analysis showed that age,TG,TSH were independent risk factors influencing IMT（standardized regression coefficient =0.170,0.240,0.377,P〈0.05）;after adjusted BMI,TC,LDL-C,apolipoprotein B,age,TG,TSH were still indepe
出处
《中国全科医学》
CAS
CSCD
北大核心
2014年第17期1955-1958,共4页
Chinese General Practice
基金
新疆维吾尔自治区自然科学基金(2011211A079)
