摘要
目的探讨缺血性心肌病(ICM)患者心功能与甲状腺功能的关系。方法选取2017年1月至2018年6月郑州大学第一附属医院心血管病医院诊断为ICM的100例患者,按照左室射血分数(LVEF)是否大于35%将上述患者分为两组,比较两组患者甲状腺功能、心脏结构相关指标等有无差异,探讨ICM患者的心功能相关指标与血清甲状腺激素水平是否具有相关性。结果LVEF≤35%组患者血清游离三碘甲状腺原氨酸(FT3)低于LVEF>35%组,组间差异有统计学意义(P<0.05),且LVEF≤35%组患者心脏彩超测得左心房内径(LAD)、左心室舒张末期内径(LVEDD)均大于LVEF>35%组,组间差异有统计学意义(均P<0.05)。ICM患者甲状腺功能与心功能的相关分析结果显示,以纽约心脏协会(NYHA)心功能分级作为ICM患者心功能状态的参考指标时,促甲状腺激素(TSH)与心功能分级呈正相关(r=0.262,P=0.008);以LVEF衡量ICM患者心功能状态时,ICM患者FT3与LVEF呈明显正相关(r=0.371,P<0.001);以脑钠肽(BNP)水平评价ICM患者心功能状态时,FT3与BNP呈负相关(r=-0.333,P=0.001),游离甲状腺素(FT4)与BNP呈负相关(r=-0.346,P<0.001)。结论ICM患者血清FT3水平随着LVEF的降低而降低,且与LVEF变化呈正相关,而与BNP水平呈负相关。因此,血清FT3水平测定可用于初步评估ICM患者的心功能状态。
Objective The aim of the present study is to explore the relationship between the cardiac function and the thyroid function of patients with ischemic cardiomyopathy(ICM).Methods The medical records of 100 patients who were diagnosed as ICM in the Cardiovascular Hospital of the First Affiliated Hospital of Zhengzhou University were collected.All the patients were admitted in the hospital from January 2017 to June 2018.According to the left ventricular ejection fraction(LVEF),the above patients were divided into two groups as group A(LVEF≤35%)and group B(LVEF>35%),and the differences of thyroid function and heart structure related indexes between the two groups were compared.The correlation between cardiac function related indexes and serum thyroid hormone level in ICM patients were explored.Results The serum free triiodothyronine(FT3)of patients with LVEF≤35%was lower than that of patients with LVEF>35%,and the difference between the two groups was statistical(P<0.05).In addition,the left atrial diameter(LAD)and left ventricular end diastolic diameter(LVEDD)of patients in the LVEF≤35%were greater than those in the LVEF>35%,and the differences were statistical(all P<0.05).The correlation analysis of thyroid function and cardiac function in patients with ICM showed that thyroid stimulating hormone(TSH)was positively correlated with cardiac function when New York Heart Association(NYHA)was used as the reference index of cardiac function in patients with ICM(r=0.262,P=0.008);FT3 was positively correlated with LVEF when LVEF was used to measure cardiac function in ICM patients(r=0.371,P<0.01);FT3 was negatively correlated with brain natriuretic peptide(BNP)(r=-0.333,P=0.001),free thyroxine(FT4)was negatively correlated with BNP(r=-0.346,P<0.001).Conclusion The level of serum FT3 in ICM patients is reduced with the decrease of LVEF,which is positively correlated with LVEF and negatively correlated with the level of BNP.Therefore,the level determination of FT3 can be used to preliminarily evaluate the cardiac funct
作者
周倩
赵洛沙
李平
ZHOU Qian;ZHAO Luo-sha;LI Ping(Department of Cardiology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;School of Medicine,Henan Medical College,Zhengzhou 451191,China)
出处
《河南医学研究》
CAS
2020年第20期3669-3672,共4页
Henan Medical Research
基金
河南省医学科技攻关计划项目(2018020537)。
关键词
缺血性心肌病
甲状腺功能
心功能
冠心病
ischemic cardiomyopathy
thyroid function
cardiac function
coronary heart disease
