摘要
目的探讨甲状腺功能与老年慢性充血性心力衰竭(CHF)患者心功能、左心室重构的关系。方法选取2013年1月—2015年1月衡水市第二人民医院收治的老年(年龄≥60岁)CHF患者90例作为CHF组,另选取同期于衡水市第二人民医院体检的老年非CHF者77例作为对照组。比较两组受检者甲状腺功能、心功能及左心室重构指标,比较不同纽约心脏病协会(NYHA)分级CHF患者甲状腺功能指标,分析甲状腺功能指标与左心室重构指标的相关性。结果对照组受检者NYHA分级均为Ⅰ级,共77例;CHF组患者NYHA分级Ⅱ级37例,Ⅲ级36例,Ⅳ级17例。CHF组患者促甲状腺素(TSH)、总三碘甲状腺原氨酸(TT3)、总甲状腺素(TT4)、游离三碘甲状腺原氨酸(FT_3)、游离甲状腺素(FT_4)水平、左心室射血分数(LVEF)低于对照组,左心室收缩末期内径(LVESD)、左心室舒张末期内径(LVEDD)、左心室质量指数(LVMI)高于对照组(P<0.05)。Ⅲ级CHF患者TSH、TT3、FT_3水平低于Ⅱ级CHF患者(P<0.05);Ⅳ级CHF患者TSH、TT3、TT4、FT_3、FT_4水平低于Ⅱ级CHF患者,TT3、FT_3、FT_4水平低于Ⅲ级CHF患者(P<0.05)。CHF组患者TSH水平与LVEDD、LVMI呈负相关(r值分别为-0.598、-0.566,P<0.05),TT3水平与LVESD、LVMI呈负相关(r值分别为-0.655、-0.832,P<0.05),TT4水平与LVESD、LVEDD呈负相关(r值分别为-0.738、-0.787,P<0.05),FT_3水平与LVMI呈负相关(r=-0.540,P<0.05),FT_4水平与LVESD呈负相关(r=-0.547,P<0.05)。结论甲状腺功能与老年CHF患者心功能、左心室重构有关,调节甲状腺功能可改善老年CHF患者心功能及左心室重构。
Objective To investigate the relationship between thyroid function and cardiac function/left ventricular remodeling of elderly patients with chronic congestive heart failure. Methods A total of 90 elderly patients with chronic congestive heart failure（ equal or over 60 years old） admitted to the Second People＇s Hospital of Hengshui from January 2013 to January 2015 were selected as A group,77 elderly patients without chronic congestive heart failure were selected as B group at the same time. Index of thyroid function, cardiac function and left ventricular remodeling were compared between the two groups,index of thyroid function was compared in elderly chronic congestive heart failure patients with different NYHA cardiac function grades,the correlation between index of thyroid function and cardiac function was analyzed. Results The NYHA cardiac function grades of B group were all Ⅰ- grade; of A group,37 cases＇ NYHA cardiac function grades were Ⅱ- grade,36 cases＇ were Ⅲ- grade,17 cases＇ were Ⅳ- grade. TSH,TT_3,TT4,FT_3,FT_4 and LVEF of A group were statistically significantly lower than those of B group,while LVESD,LVEDD and LVMI of A group were statistically significantly lower than those of B group（ P〈0. 05）. TSH,TT_3 and FT_3of chronic congestive heart failure patients with Ⅲ- grade NYHA cardiac function grades were statistically significantly lower than those of chronic congestive heart failure patients with Ⅱ- grade NYHA cardiac function grades（ P〈0. 05）; TSH,TT_3,TT4,FT_3 and FT_4of chronic congestive heart failure patients with Ⅳ- grade NYHA cardiac function grades were statistically significantly lower than those of chronic congestive heart failure patients with Ⅱ- grade NYHA cardiac function grades,TT_3,FT_3 and FT_4of chronic congestive heart failure patients with Ⅳ- grade NYHA cardiac function grades were statistically significantly lower than those of chronic congestive heart failure patients with Ⅲ- grade NYHA cardiac function grades. Of patients with chronic congestive heart failure,TSH was negatively correlated with LVEDD（ r =- 0. 598）and LVMI（ r =- 0. 566）,respectively（ P〈0. 05）,TT_3 was negatively correlated with LVESD（ r =- 0. 655） and LVMI（ r=- 0. 832）, respectively（ P〈0. 05）, TT4 was negatively correlated with LVESD（ r =- 0. 7_38） and LVEDD（ r =-0. 787）,respectively（ P〈0. 05）,FT_3 was negatively correlated with LVMI（ r =- 0. 540,P〈0. 05）,FT_4 was negatively correlated with LVESD（ r =- 0. 547,P〈0. 05）. Conclusion Thyroid function has certain correlations with cardiac function /left ventricular remodeling of elderly patients with chronic congestive heart failure,clinicians should reasonably adjust the thyroid function to improve the cardiac function / left ventricular remodeling.
出处
《实用心脑肺血管病杂志》
2016年第4期28-31,共4页
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
关键词
心力衰竭
老年人
心室重构
心功能
甲状腺功能
Heart failure
Aged
Ventricular remodeling
Cardiac function
Thyroid function
