摘要
目的探讨急性冠脉综合征(ACS)患者甲状腺激素游离三碘甲状腺原氨酸(FT3)和反三碘甲状腺原氨酸(rT3)的变化及FT3与C反应蛋白(CRP)的关系。方法将155例ACS患者分为不稳定心绞痛(UAP)、急性ST段抬高性心肌梗死(STEMI)及急性非ST段抬高性心肌梗死(NSTEMI)3个亚组。选取同期经冠状动脉造影检查排除冠心病的患者为对照组,共67例。测定各组血清FT3、rT3和CRP等。结果 ACS组FT(33.92±0.72)pmol/L低于对照组(4.59±0.65)pmol/L,差别有统计学意义(P<0.01)。STEMI组FT(33.79±0.62)pmol/L、NSTEMI组FT(33.63±0.70)pmol/L低于UAP组(4.22±0.72)pmol/L,差别有统计学意义(P<0.05)。STEMI组与NSTEMI组之间FT3差别无统计学意义。ACS组血清rT(31.46±0.73)nmol/L高于对照组(0.76±0.18)nmol/L,NSTEMI组血清rT(33.63±0.70)nmol/L高于UAP组(4.22±0.72)nmol/L和STEMI组(3.79±0.62)nmol/L,差别均有统计学意义(P<0.05)。UAP组血清rT3与STEMI组间差别无统计学意义。ACS组血清CRP(8.23±8.63)mg/L高于对照组(3.60±3.87)mg/L,STEMI组血清CRP(10.41±9.80)mg/L高于UAP组(5.46±4.93)mg/L,差别均有统计学意义(P<0.01)。NSTEMI组血清CRP(9.18±10.20)mg/L介于UAP与STEMI组之间,但与两组的差别均无统计学意义。ACS患者FT3与CRP低度负相关(r=-0.161,P<0.05)。结论 ACS患者表现为低T3综合征,血清FT3、rT3水平测定对疾病严重程度判断有一定参考价值。ACS患者血清CRP升高,反映炎症在ACS的发生、发展过程中发挥一定的作用。FT3与CRP反应有低相关性,仍需进一步研究。
Objective To evaluate the changes of serum thyroid hormones in the patients with acute coronary syndrome （ACS）. Methods 155 patients with ACS were divided into three groups as unstable angina pectoris （UAP） group, ST segment elevated myocardial infarction （STEMI） group and non-ST segment elevated myocardial infarction （NSTEMI） group, according to the symptoms, physical and laboratory examinations. There were 67 patients in the control group recruited during same period and detected no remarkable stenoses of their coronary angiography. The concentration of serum FT3 and rT3 was determined by radioimmunity （RIA）, and the concentration of the C reactive protein （CRP） was determined by immunotm＇bidimetry （ITM）. Results The serum level of FT3 of the ACS patients （3.92±0.72 pmol/L） was lower than that in the control group （4.59±0.65 pmol/L, P〈0.O1）, the serum level of FT3 of the patients in STEMI group （3.79±0.62 pmol/L） or in NSTEMI group （3.63±0.70 pmol/L） was lower than those in UAP group （4.22±0.72 pmol/L,P〈0.05）. The serum level of rT3 of ACS patients （1.46±0.73 mnol/L） was higher than that in the control group （0.76±0.18 nmol/L,P〈0.01）,the rT3 in the patients with NSTEMI （3.63±0.70 nmol/L） was higher than those in both of UAP （4.22±0.72 nmol/L, P〈O.05） and STEMI （3.79±0.62 nmol/L, P〈0.05） group. The serum level of CRP of all the patients with ACS （8.23±8.63 mg/L） was higher than that of the control group （3.60±3.87 mg/L,P〈0.01）,the CRP in the patients with STEMI （10.41±9.80 mg/L） was higher than that in UAP （5.46±4.93 mg/L） group,the serum level of CRP of the patients with NSTEMI （9.18±10.20 rag/L） was higher than that in gAP,but lower than that in NSTEMI group,there were no significant difference in the patients with NSTEMI and either of the sub-groups （P〉0.05）. The concentration of serum FF3 was negatively correlated with the serum level of CRP （r=--0.16 l, P〈0.05 ）. Conclusion The results of this study demonstrate that low T3 syndrome exist in the patients with ACS. It is helpful to the differential diagnosis to determinate the serum level of FT3 and rT3 at the early stage of ACS. The serum level detection of CRP has clinical application value to the early diagnosis and condition evaluation of ACS. The change of thyroid hormones negatively correlates with CRP in the patients of ACS, but further studies are needed.
出处
《中国慢性病预防与控制》
CAS
北大核心
2010年第1期52-54,共3页
Chinese Journal of Prevention and Control of Chronic Diseases
关键词
甲状腺激素
急性冠脉综合征
C反应蛋白
Thyroid hormone
Acute coronary syndrome
C reactive protein （CRP）
