摘要
目的探讨低三碘甲状腺原氨酸(T_(3))综合征对心力衰竭(心衰)患者心功能及不良心血管事件发生的影响。方法回顾性分析2020年8月至2022年6月于青岛市立医院就诊的200例心衰患者的临床资料,根据甲状腺功能分为低T_(3)组(n=38)和甲状腺功能正常组(n=162)。比较两组基线资料、血清游离三碘甲状腺原氨酸(FT_(3))、游离甲状腺素(FT_(4))、促甲状腺激素(TSH),低T_(3)组不同心功能分级患者血清FT_(3)、FT_(4)、TSH水平比较,分析血清FT_(3)与心功能分级的相关性,并比较两组患者6个月不良心血管事件发生率。结果低T_(3)组与甲状腺功能正常组患者美国纽约心脏病协会(NYHA)分级、左室射血分数(LVEF)、N末端脑钠肽前体(NT-proBNP)比较,差异有统计学意义(P<0.05);低T_(3)组血清FT_(3)水平明显低于甲状腺功能正常组,差异有统计学意义(P<0.05);低T_(3)组心功能分级Ⅳ级患者血清FT_(3)水平均低于Ⅱ级和Ⅲ级患者,Ⅲ级患者血清FT_(3)水平低于Ⅱ级患者,差异有统计学意义(P<0.05);经Pearson相关性分析显示,血清FT_(3)和心功能分级呈负相关(P<0.05);低T_(3)组6个月不良心血管事件发生率明显高于甲状腺功能正常组(P<0.05)。结论低T_(3)综合征对心衰患者心功能影响较大,显著增加不良心血管事件发生率。
Objective To discuss the influence of low tri-iodothyronine(T_(3))syndrome on heart function and occurrence of major adverse cardiovascular events(MACE)in patients with heart failure(HF).Methods The clinical materials of HF patients(n=200)were retrospectively analyzed in Qingdao Municipal Hospital from Aug.2020 to June 2022.All patients were divided,according to their thyroid function,into low T_(3)group(n=38)and normal group(n=162).The baseline materials and levels of serum free triiodothyronine(FT_(3)),free thyroxine(FT_(4))and thyroid stimulating hormone(TSH)were compared between 2 groups,and levels of serum FT_(3),FT_(4)and TSH were compared in patients with different heart function grades in low T_(3)group.The correlation between serum FT_(3)level and heart function grades was analyzed,and incidence of MACE was compared between 2 groups within 6 months.Results The differences in heart function grades of NYHA classification of heart function,left ventricular ejection fraction(LVEF)and N-terminal pro-brain natriuretic peptide(NT-proBNP)had statistical significance between low T_(3)group and normal group(P<0.05).The level of serum FT_(3)was significantly lower in low T_(3)group than that in normal group(P<0.05).In low T_(3)group,the level of serum FT_(3)was lower in patient withⅣgrade of NYHA classification of heart function than that in patients withⅡandⅢgrades,and was lower in patients withⅢgrade than that in patients withⅡgrade(P<0.05).The results of Pearson correlation analysis showed that level of serum FT_(3)was negatively correlated to heart function grades(P<0.05).The incidence of MACE was significantly higher in low T_(3)group than that in normal group within 6 months(P<0.05).Conclusion The influence of low T_(3)syndrome has a great influence on heart function and can promote MACE incidence in HF patients.
作者
窦洪珊
杜海真
程骞
Dou Hongshan;Du Haizhen;Cheng Qian(Qingdao Hospital,University of Healthy and Rehabilitation Sciences(Qingdao Municipal Hospital),Qingdao 266000,China;不详)
出处
《中国循证心血管医学杂志》
2023年第9期1124-1126,1129,共4页
Chinese Journal of Evidence-Based Cardiovascular Medicine
关键词
心力衰竭
低T_(3)综合征
不良心血管事件
心功能
Heart failure
Low tri-iodothyronine syndrome
Major adverse cardiovascular events
Heart function
