冠心病患者亚临床甲状腺功能减退症与冠状动脉Gensini评分的相关性研究被引量：10

Correlation of subclinical hypothyroidism and Gensini's score in patients with coronary artery disease

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摘要目的探讨冠心病患者亚临床甲状腺功能减退症（亚临床甲减）与冠状动脉狭窄程度的相关性。方法选择2011年1月—2012年12月于广西医科大学第四附属医院就诊,并行冠状动脉造影（CAG）或经皮冠状动脉介入治疗（PCI）的患者350例。根据冠状动脉造影的结果分为对照组（冠脉造影正常）90例,冠心病组260例,检测FT3、FT4和s TSH,收集其一般临床资料及冠状动脉造影结果,冠心病患者冠状动脉狭窄程度依据Gensini评分标准进行评分,按Gensini积分分成3组（Gensini积分〈30分组、30~60分组、〉60分组）。比较对照组及冠心病组亚临床甲减的发病率及不同Gensini积分时冠心病亚临床甲减的发病率及s TSH水平;行多因素相关性分析分析亚临床甲减与冠心病Gensini的相关性。结果（1）冠心病组亚临床甲减发病率（20.77%）高于正常对照组（12.22%）（P〈0.05）;（2）冠心病Gensini积分〉60分组亚临床甲减发病率为26.83%,显著高于Gensini积分〈30分组（17.58%）和30~60分组（18.39%）,P〈0.05。s TSH水平Gensini积分〉60分组高于Gensini积分〈30分组和30~60分组（P〈0.01）;（3）亚临床甲减者发生冠心病的危险度是甲状腺功能正常者的2.53倍,冠脉病变Gensini积分与s TSH呈正相关（r=0.548,P〈0.05）。结论亚临床甲减是冠心病的危险因素之一,且与冠状动脉狭窄程度相关。 Objective To explore the relationship between subclinical hypothyroidism and severity of coronary artery stenosis in patients with coronary artery disease. Methods We studied 350 patients who underwent elective coronary angiography or Percutaneous Coronary Intervention. Patients were divided into two groups： normal coronary artery group（ control group,n = 90） and coronary artery heart disease group（ CHD group,n = 260）. Serum levels of free triiodothyronine（ FT3）,free thyroxine（ FT4） and thyrotropin（ thyroid stimulating hormone,TSH） were tested. General clinical data and results of coronary angiography were collected. Gensini score was determined based on the degree of coronary artery stenosis in patients with coronary artery disease. The patients were further divided into three groups according to Gensini score： 30 group,30- 60 group,and 60 group. Incidence of subclinical hypothyroidism was compared between coronary heart disease group and control group. Correlation of different Gensini score in patients with coronary heart disease and level of s TSH in subclinical hypothyroidism was studied. Multi- factor correlation analysis was performed. Results（ 1） The prevalence of subclinical hypothyroidism in CHD group（ 20. 77%） was higher than that in control group（ 12. 22%）（ P〈0. 05）.（ 2）The prevalence of subclinical hypothyroidism in Gensini＇s score 〉60 group（ 26. 83%） was higher than that in Gensini＇s score 30 group（ 17. 58%） and Gensini＇s score 30- 60 group（ 18. 39%）（ P〈0. 05）.（ 3） The concentration of s TSH in Gensini＇s score 60 group was higher than that in Gensini＇s score 30 group（ 17. 58%） and Gensini＇s score between 30 to 60 group（ 18. 39%）（ P〈0. 05）.（ 4） Logistic regression analysis revealed that the incidence of CHD in subclinical hypothyroidism patients was 2. 53 times than euthyroidism patients. Gensini＇s score had a significant correlation with TSH level（ r = 0. 548,P〈0. 05）. Conclusion Subclinical hypothyroidism is one of the risk factors for coronary artery disease and has positive relationship with severity of coronary artery stenosis in patients with coronary artery disease.

作者陈刚丁彦春

机构地区广西医科大学第四附属医院心内科大连医科大学附属第二医院心内科

出处《大连医科大学学报》 CAS 2015年第3期254-257,共4页 Journal of Dalian Medical University

关键词亚临床甲减冠心病 GENSINI评分 subclinical hypothyroidism coronary artery disease Gensini＇s score

分类号 R541.4 [医药卫生—心血管疾病]

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