甲状腺功能异常与冠状动脉病变严重程度及预后的关系

摘要

Objective:To explore the relationship among severity of coronary artery lesion and prognosis and thyroid dysfunc‐tion ,.Methods:Clinical data of 577 patients undergoing coronary angiography (CAG) were retrospectively analyzed .Ac‐cording to thyroid function before CAG ,they were divided into euthyroidism group (n=507) ,hypothyroidism group (n=49) and hyperthyroidism group (n=21) .Gensini score was used to evaluate severity of coronary lesion .Patients were fol‐lowed up for one year after CAG ,and the main observing endpoints were hospitalization incidents caused by angina pectoris onset ,nonfatal myocardial infarction and heart failure .Results:Compared with euthyroidism group ,severity of coronary lesion was more severe (proportion of severe patients :22.3% vs .36.7% ) , incidence rate of coronary heart disease (59.4% vs .81.6% ) , hospitalization rate caused by angina pectoris onset (7.3% vs .14.3% ) in hypothyroidism group ;there were significant rise in incidence rate of coronary spasm (3.0% vs .33.3% ) and hospitalization rate caused by angina pectoris onset (7.5% vs .28.6% ) in hyperthyroidism group , P< 0.05 or < 0.01;in composite cardiovascular event (12.8% vs .26.5% ,38.1% ) in hypothyroidism group and hyperthyroidism group , P<0.05 all .Conclusion:Detection rate of coronary heart disease is higher ,coronary lesion is more severity and incidence rate of adverse cardiovascular event is significant rise in patients with thyroid dysfunction .%目的：探讨甲状腺功能异常与冠状动脉病变严重程度及预后的关系。方法：回顾性分析行冠脉造影（CAG ）的患者577例的临床资料，按造影前甲状腺功能分为甲状腺功能正常组（507例）、甲减组（49例）和甲亢组（21例）。运用Gensini评分评价冠脉病变严重程度， CAG后随访1年，主要观察终点为心绞痛发作住院、非致命性心肌梗死和心力衰竭事件。结果：与甲状腺功能正常组比较，甲减组冠脉病变程度更严重（重度：22.3％比36.7％），冠心病发生率（59.4％比81.6％），心绞痛发作住院率（7.5％比14.3％）显著升高；甲亢组冠脉痉挛的发生率（3.0％比33.3％）、心绞痛发作住院率（7.5％比28.6％）明显升高（ P＜0.05或＜0.01）；甲减组和甲亢组复合心血管事件的发生率（12.8％比26.5％、38.1％）明显升高（ P均＜0.05）。结论：甲状腺功能异常患者冠心病检出率更高，冠脉病变程度更重，心血管不良事件发生率显著增加。