甲状腺功能正常人群甲状腺激素水平与冠心病的相关性研究

摘要

目的：探讨甲状腺功能正常人群甲状腺激素水平与冠心病的相关性。方法选取2010—2012年海口市第三人民医院心血管内科收治的疑诊冠心病患者490例，甲状腺功能均正常，根据冠状动脉造影结果分为冠心病组250例和非冠心病组240例。比较两组患者一般资料、甲状腺激素水平〔三碘甲状腺原氨酸（T3）、甲状腺素（T4）、游离三碘甲状腺原氨酸（FT3）、游离甲状腺素（FT4）及促甲状腺激素（TSH）〕和血脂指标〔总胆固醇（TC）、三酰甘油（TG）、高密度脂蛋白胆固醇（HDL - C）和低密度脂蛋白胆固醇（ LDL - C）〕，冠心病危险因素的分析采用多因素Logistic 回归分析。结果冠心病组患者年龄、吸烟率、高血压和糖尿病发生率高于非冠心病组，HDL - C 和 FT3水平低于非冠心病组（P <0.05）；两组患者性别、体质指数（BMI）、冠心病家族史阳性率及 TC、TG、LDL - C、T3、T4、FT4、TSH 水平比较，差异无统计学意义（P >0.05）。多因素 Logistic 回归分析结果显示，高龄是冠心病〔回归系数=0.337，OR =1.401，95% CI（1.347，1.457）〕的危险因素，而高水平 FT3〔回归系数=-0.603，OR =0.547，95% CI （0.412，0.727）〕和高水平 HDL - C〔回归系数=-1.363，OR =0.256，95% CI（0.158，0.414）〕是冠心病的保护因素。结论高水平 FT3是甲状腺功能正常人群冠心病的保护因素，因此应重点预防甲状腺功能正常但 FT3水平较低的人群冠心病的发生。%Objective To investigate the correlation between thyroid hormone levels and coronary heart disease in people with normal thyroid function. Methods From 2010 to 2012,a total of 490 suspected coronary heart disease patients with normal thyroid function were selected in the Department of Cardiovasology,the Third People's Hospital of Haikou,and they were divided into A group(with coronary heart disease,n = 250)and B group(without coronary heart disease,n = 240)according to coronary angiography results. General information,thyroid hormone levels( including T3 ,T4 ,FT3 ,FT4 and TSH) and blood lipids index( including TC,TG,HDL - C and LDL - C) were compared between the two groups,and multivariate Logistic regression analysis was used to analyze the risk factors of coronary heart disease. Results Age,smoking rate, incidence of hypertension and diabetes of A group were statistically significantly higher than those of B group,while HDL - C and FT3 of A group were statistically significantly higher than those of B group(P < 0. 05). No statistically significant differences of gender,BMI,positive rate of family history of coronary heart disease,TC,TG,LDL - C,T3 ,T4 ,FT4 or TSH was found between the two groups(P > 0. 05). Multivariate Logistic regression analysis showed that,advanced age was one of risk factors of coronary heart disease〔β = 0. 337,OR = 1. 401,95% CI(1. 347,1. 457)〕,while increased FT3 〔β = - 0. 603,OR =0. 547,95% CI(0. 412,0. 727)〕and increased HDL - C〔 β = - 1. 363,OR = 0. 256,95% CI(0. 158,0. 414)〕 were protective factors of heart disease. Conclusion Increased FT3 is one of protective factors of heart disease,people with lower FT3 and normal thyroid function should be pay more attentions to,in order to prevent the occurrence of coronary heart disease.