摘要
目的研究亚临床甲状腺功能减退症(SCH)对冠心病(CHD)患者脂质代谢、内皮功能损伤及斑块稳定性的影响。方法随机抽取2019年1月至2019年12月我院128例CHD患者为样本,详细收集一般资料并完成脂质代谢、斑块稳定性及内皮功能损伤等相关检查,根据血清促甲状腺素(TSH)将患者分为SCH组(>4.8 mU/L)和对照组(≤4.8 mU/L)并比较两组各项指标差异,分析TSH与血脂、冠脉内皮细胞功能及斑块稳定性相关参数的关系,探讨影响斑块稳定性的危险因素。结果SCH组年龄、TSH、三酰甘油(TG)、低密度脂蛋白(LDL-C)、载脂蛋白B(ApoB)、内皮素-1(ET-1)、斑块负荷(PB)、脂核负荷及易损斑块占比高于对照组,一氧化氮(NO)、内皮依赖性血管舒张功能(FMD)和纤维帽厚度均低于对照组,差异有统计学意义(P<0.05);Pearson积差分析显示,SCH合并管CHD患者血清TSH水平与TG、LDL-C、ApoB、ET-1、PB和脂核负荷呈明显正相关性(P<0.05),与NO和FMD呈明显负相关性(P<0.05);易损斑块组TSH、LDL-C、ApoB和ET-1水平高于稳定斑块组,NO和FMD低于稳定斑块组,差异有统计学意义(P<0.05);吸烟史、TSH、LDL-C、NO和ET-1均为影响冠脉斑块稳定性的独立危险因素(P<0.05)。结论SCH可对CHD患者脂质代谢、血管内皮功能和斑块稳定性造成不利影响,增加易损斑块形成风险。
Objective To study the effects of subclinical hypothyroidism(SCH)on lipid metabolism,plaque stability and endothelial function damage in patients with coronary heart disease(CHD).Methods A total of 128 CHD patients in our hospital were randomly selected from January 2019 to December 2019 as samples.The general data were collected in detail and related examinations of lipid metabolism,plaque stability,and endothelial function damage were completed.According to serum thyroid stimulating hormone(TSH),the patients were divided into SCH group(>4.8 mU/L)and control group(≤4.8 mU/L).The differences in various indicators were compared between the two groups,and the relationship between TSH and blood lipids,coronary endothelial cell function and plaque stability-related parameters were analyzed,and the risk factors that affected plaque stability were explored.Results The proportions of age,TSH,triacylglycerol(TG),low density lipoprotein-cholesterol(LDL-C),apolipoprotein B(ApoB),endothelin-1(ET-1),plaque load(PB),lipid nuclear load and vulnerable plaques in SCH group were higher than those in control group,and the nitric oxide(NO),flow-mediated dilatation(FMD)and fibrous cap thickness were lower than those in control group(P<0.05).Pearson product difference analysis showed that serum TSH level of patients with SCH and CHD was significantly positively correlated with TG,LDL-C,ApoB,ET-1,PB and lipid nuclear load(P<0.05),and was significantly negatively correlated with NO and FMD(P<0.05).The levels of TSH,LDL-C,ApoB and ET-1 in vulnerable plaque group were higher than those in stable plaque group while the levels of NO and FMD were lower than those in stable plaque group(P<0.05).Smoking history,TSH,LDL-C,NO and ET-1 were the independent risk factors affecting the coronary plaque stability(P<0.05).Conclusion SCH can adversely affect lipid metabolism,vascular endothelial function and plaque stability in patients with CHD,and increase the risk of vulnerable plaque formation.
作者
杨娜
梁文龙
谢会娟
YANG Na;LIANG Wenlong;XIE Huijuan(Department of Laboratory Medicine,Luohe Hospital of Chinese Medicine,Luohe 462000,Henan Province,China.)
出处
《实验与检验医学》
CAS
2021年第3期547-551,共5页
Experimental and Laboratory Medicine
关键词
冠心病
亚临床甲状腺功能减退症
血脂
易损斑块
血管内皮功能
Coronary heart disease
Subclinical hypothyroidism
Blood lipids
Vulnerable plaques
Vascular endothelial function
