摘要
【摘要】目的分析云南地区慢性心力衰竭(CHF)患者甲状腺激素(TH)变化特点。方法选取2009—2015年大理大学第一附属医院和曲靖市第一人民医院收治的CHF患者1 083例,其中纽约心脏病协会(NYHA)分级Ⅱ级286例,Ⅲ级439例,Ⅳ级358例;心力衰竭类型:射血分数正常的心力衰竭(HFpEF)651例,射血分数下降的心力衰竭(HFrEF)285例,147例患者左心室射血分数(LVEF)数据缺失;基础疾病:冠心病277例,高血压心脏病298例,其他508例。记录CHF患者低三碘甲状腺原氨酸(T_3)综合征发生情况,并比较不同NYHA分级、心力衰竭类型、基础疾病CHF患者TH水平。结果1 083例CHF患者发生低T_3综合征226例,发生率为20.9%。NYHA分级Ⅳ级患者游离三碘甲状腺原氨酸(FT_3)、总三碘甲状腺原氨酸(TT_3)水平低于NYHA分级Ⅱ、Ⅲ级患者(P<0.05);不同NYHA分级CHF患者游离甲状腺(FT_4)、总甲状腺(TT_4)、促甲状腺激素(TSH)水平比较,差异无统计学意义(P>0.05)。HFrEF患者FT_3、TT_3水平低于HFpEF患者(P<0.05);HFrEF与HFpEF患者FT_4、TT_4、TSH水平比较,差异无统计学意义(P>0.05)。不同基础疾病患者FT_3、TT_3、FT_4、TT_4、TSH水平比较,差异无统计学意义(P>0.05)。结论云南地区CHF患者低T_3综合征发生率较高,以TT_3、FT_3水平变化为主,且TT_3、FT_3水平随着CHF患者心功能恶化程度加重、LVEF降低而降低。
Objective To investigate on changes of thyroid hormone levels in chronic heart failure patients in Yunnan.Methods A total of 1,083 patients with chronic heart failure were selected in the First Affiliated Hospital of Dali University and the First People's Hospital of Qujing from 2009 to 2015,thereinto 286 cases withⅡ-grade NYHA grading were served as A1 group,439 cases withⅢ-grade NYHA grading were served as A2 group,358 cases withⅣ-grade NYHA grading were served as A3 group;651 cases with preserved ejection fraction were served B1 group,285 cases with reduced ejection fraction were served B2 group,and LVEF data was deficient in 147 cases;277 cases with coronary heart disease were served as C1 group,298 cases with hypertensive heart disease were served as C2 group,508 cases with other underlying diseases were served as C3 group.Incidence of low T3 syndrome was recorded,thyroid hormone levels were compared in A1 group,A2 group and A3 group,between B1 group and B2 group,in C1 group,C2 group and C3 group.Results The incidence of low T3 syndrome was 20.9%(226/1 083).FT3 and TT3 in A3 group were statistically significantly lower than those in A1 group and A2 group(P<0.05),while no statistically significant differences of FT4,TT4 or TSH was found in A1 group,A2 group and A3 group(P>0.05).FT3 and TT3 in B1 group were statistically significantly lower than those in B2 group(P<0.05),while no statistically significant differences of FT4,TT4 or TSH was found between B1 group and B2 group(P>0.05).No statistically significant differences of FT3,TT3,FT4,TT4 or TSH was found in C1 group,C2 group and C3 group(P>0.05).Conclusion Incidence of low T3 syndrome is relatively high in chronic heart failure patients in Yunnan,which mainly performs as changes of TT3 and FT3,meanwhile TT3 and FT3 reduced as deterioration of cardiac function exacerbated and LVEF decreased in patients with chronic heart failure.
作者
王芳芳
吴新华
陈章荣
杨云贵
董瑜
杨瑛
刘宏
张健
WANG Fangfang;WU Xin-hua;CHEN Zhang-rong;YANG Yun-gui;DONG Yu;YANG Ying;LIU Hong;ZHANG Jian(Department of Cardiology,the First Affiliated Hospital of Dali University,Dali 671000,China;Department of Cadre Wellness,the First People's Hospital of Qujing,Qujing 655000,China;Peking Union Medical College of Chinese Academy of Medical Science,National Center for Cardiovascular Disease,Fuwai Cardiovascular Disease Hospital,Heart Failure Center,Beijing 100037,China)
出处
《实用心脑肺血管病杂志》
2018年第12期72-75,共4页
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
基金
“十二五”国家科技支撑计划重大项目心力衰竭项目(2011BA111B02)
国家自然科学基金资助项目(81560073)
