摘要
目的探讨低三碘甲状腺原氨酸(T3)综合征对老年冠状动脉粥样硬化性心脏病(冠心病)患者病情严重程度及预后影响。方法回顾性分析2015年10月至2017年10月于解放军第960医院收治的确诊为冠心病并行冠状动脉(冠脉)造影的患者208例。依据甲状腺功能分为甲状腺功能正常组(158例)与低T3组(50例)。记录患者基线临床资料,包括年龄、性别、体质指数(BMI)、吸烟史、饮酒史、高血压史、糖尿病史、心律失常史、脑血管病史、外周血管疾病史等合并疾病史、经皮冠脉介入治疗(PCI)史、冠脉旁路移植术(CABG)史等。入院次日检测游离T3(FT3)、游离T4(FT4)、促甲状腺素(TSH)、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)。运用Gensini评分评价冠脉病变严重程度。随访2年,记录全因性死亡、心绞痛发作住院、非致命性心肌梗死、心力衰竭等复合终点事件的发生情况。结果两组患者基线的年龄、性别、BMI、吸烟史、饮酒史、合并疾病史、PCI史、CABG史、HDL-C比较,差异均无统计学意义(P>0.05);低T3组患者TC、TG和LDL-C显著高于甲状腺功能正常组(P<0.05)。低T3组冠脉病变程度高于甲状腺功能正常组(P<0.05)。多因素Logistic回归分析显示,FT3、TC、TG和LDL-C均为老年冠心病的独立危险因素(P<0.05)。低T3组患者心绞痛发作住院、复合终点事件发生率显著高于甲状腺功能正常组,无事件生存率显著低于甲状腺功能正常组(P<0.05)。结论低T3综合征可增加老年冠心病患者冠脉病变严重程度,且预后不良。
Objective To discuss the influence of low tri-iodothyronine(T3)syndrome on illness severity and prognosis in elderly patients with coronary heart disease(CHD).Methods CHD patients(n=208)undergone coronary angiography(CAG)were chosen and analyzed retrospectively from Chinese PLA the 960th Hospital from Oct.2015 to Oct 2017.All patients were divided,according to thyroid function,into normal group(n=158)and low T3 group(n=50).The baseline clinical materials were recorded including age,gender,BMI,smoking history,drinking history,hypertension history,diabetes history,arrhythmia history,cerebrovascular disease history,peripheral vascular disease history,PCI history and CABG history.The levels of free T3(FT3),free T4(FT4),thyroid stimulating hormone(TSH),total cholesterol(TC),triglyceride(TG),high-density lipoprotein-cholesterol(HDL-C)and low-density lipoprotein-cholesterol(LDL-C)were detected on the second day after hospitalization.The severity of CHD was reviewed by using Gensini scoring.After followed up for 2 y,the incidence of composite end-point events were recorded including all-cause mortality,hospitalization due to angina attack,non-lifethreatening myocardial infarction and heart failure.Results The difference in age,gender,BMI,smoking history,drinking history,complicating disease history,PCI history,CABG history and HDL-C level had no statistical significance between 2 groups(P>0.05).The levels of TC,TG and LDL-C were significantly higher in low T3 group than those in normal group(P<0.05).The severity of coronary artery lesion was higher in low T3 group than that in normal group(P<0.05).The results of multi-factor Logistic regression analysis showed that FT3,TC,TG and LDL-C were independent risk factors of senile CHD(P<0.05).The incidence rates of hospitalization due to angina attack and composite end-point events were significantly higher,and event free survival rate was significantly lower in low T3 group than those in normal group(P<0.05).Conclusion Low T3 syndrome can promote the severity of coronary arter
作者
王国峰
崔玉玲
李宁
刘娜娜
Wang Guofeng;Cui Yuling;Li Ning;Liu Nana(Third Departments of Geriatrics,960th Hospital of Chinese PLA,Jinan 250031,China;不详)
出处
《中国循证心血管医学杂志》
2020年第10期1255-1257,1261,共4页
Chinese Journal of Evidence-Based Cardiovascular Medicine
关键词
冠心病
低T3综合征
病情严重程度
预后
Coronary heart disease
Low tri-iodothyronine syndrome
Severity of illness
Prognosis
