摘要
目的观察甲状腺功能正常的患者血清促甲状腺激素与冠状动脉病变严重程度的关系。方法选择274例行冠状动脉造影的患者,测定体质量指数(body mass index,BMI)、腰围(waist circumference,WC)、空腹葡萄糖(fasting blood glucose,FBG)、糖化血红蛋白(glycosylated hemoglobin,HbA1c)、总胆固醇(total cholesterol,TC)、三酰甘油(triglyceride,TG)、低密度脂蛋白胆固醇(low density lipoprotein-cholesterol,LDL-C)、高密度脂蛋白胆固醇(high density lipoprotein-cholesterol,HDL-C)、收缩压(systolic blood pressure,SBP)、舒张压(diastolic blood pressure,DBP)、三碘甲状腺素(triiodothyronine,T_3)、甲状腺素(thyroxine,T_4)、游离三碘甲腺原氨酸(free triiodothyronine,FT_3)、血清游离甲状腺素(free thyroxine,FT_4)和促甲状腺激素(thyroid stimulating hormone,TSH)等。根据有无冠心病、冠状动脉病变严重程度及血清TSH水平进行分组,采用Spearman相关分析评估TSH相对表达量与冠状动脉硬化的相关性,采用多元Logistic多元回归分析评估TSH与冠状动脉病变及其严重病变严重程度关系。结果严重病变组的TSH水平明显高于单支病变组(P=0.002)。Spearman相关分析显示:TSH水平与冠状动脉是否为严重病变呈正相关(r=0.128,P=0.034)。Logistic回归分析显示:年龄(OR=1.025,95%CI:1.000~1.050)和TSH(OR=1.454,95%CI:1.123~1.884)是冠状动脉是否严重病变的独立危险因素。结论在甲状腺功能正常范围内血清TSH水平升高与冠心病的发生无显著相关,但是在已发生冠状动脉病变的患者中,TSH是冠状动脉是否严重病变的独立危险因素。
Objective To investigate the correlation between serum thyroid stimulating hormone（ TSH） and the severity of coronary atherosclerotic heart disease（ CAD） in patients with normal thyroid function. Methods Total 274 subjects with suspicious coronary heart disease and normal thyroid function underwent coronary angiography during November 2015 to January 2016. The clinical data of patients were collected and analyzed,including body mass index（ BMI）,waist circumference（ WC）,fasting blood glucose（ FBG）,glycosylated hemoglobin（ HbA1c）,total cholesterol（ TC）,triglyceride（ TG）,low density lipoprotein-cholesterol（ LDL-C）,high density lipoprotein-cholesterol（ HDL-C）,systolic blood pressure（ SBP）,diastolic blood pressure（ DBP）,triiodothyronine（ T3）,thyroxine（ T4）,free triiodothyronine（ FT3）,free thyroxine（ FT4）,thyroid-stimulating hormone（ TSH）. Spearman simple correlation analysis and multivariate Logistic regression analysis was applied to examine the correlation between TSH levels and the severity of CAD. Results There was no significant difference in TSH level between the CAD group and non-CAD group（ P = 0. 942）. The TSH levels in CAD patients with severe lesion were significantly higher than those with mild lesion（ P =0. 002）. Spearman simple correlation analysis showed that TSH levels were positive correlated with the severity of coronary artery disease（ r = 0. 128,P= 0. 034）. Multivariate Logistic regression analysis showed that age（ OR = 1. 025,95%CI： 1. 000-1. 050） and TSH level（ OR = 1. 454,95%CI： 1. 123-1. 884）were independent risk factors for severe coronary lesions. Conclusion The serum TSH level is not a risk factor for coronary heart disease in individuals with normal thyroid function. But the serum TSH level is correlated with the severity of coronary artery lesions in CAD patients.
作者
曹福明
王华
唐兆生
冯波
CAO Fu-Ming;WANG Hua;TANG Zhao-sheng;FENG Bo(Dept.of Endocrinology,East Hospital,Tongji University,Shanghai 200120,China)
出处
《同济大学学报（医学版）》
CAS
2018年第3期48-52,共5页
Journal of Tongji University(Medical Science)
基金
上海市浦东新区卫生系统优秀青年医学人才计划(PWRq2012-08)
关键词
促甲状腺激素
冠心病
危险因素
thyroid stimulating hormone
coronary artery disease
risk factors
