摘要
目的探讨冠状动脉微血管性心绞痛(coronary microvascular angina,CMVA)患者亚临床型甲状腺功能减退症(subclinical hypothyroidism,SCH)对心脏射血功能的影响.方法应用智业电子病历系统选择2015年5月至2019年5月在我院诊断为CMVA的患者165例为CMVA组,根据是否伴SCH再分亚组为:甲功正常组和CMVA伴SCH组;选择同期健康查体者116例为对照组.应用化学发光免疫法测定甲状腺激素和生化指标,采用彩色超声心动图评价心脏功能.结果CMVA组SCH患病率和TPOAb阳性率显著高于对照组(29.7%比16.4%,26.1%比18.1%;P<0.05).CMVA组TC、TG、HDL-C、LDL-C、CRP、尿酸、ApoB和E/A与对照组比较差异有统计学意义[TC:(5.25±1.26)mmol/L比(4.53±0.65)mmol/L;TG:(1.33±0.67)mmol/L比(1.02±0.31)mmol/L;HDL-C:(1.18±0.28)mmol/L比(1.56±0.33)mmol/L;LDL-C:(3.25±0.83)mmol/L比(3.02±0.18)mmol/L;CRP:(3.21±0.55)mg/L比(2.83±0.33)mg/L;尿酸:(357±72)mmol/L比(268±81)mmol/L;ApoB(1.17±0.30)g/L比(0.86±0.27)g/L;E/A:(0.78±1.54)比(1.15±1.43);P均<0.05].CMVA伴SCH组与甲功正常组比较,E/A比值显著降低(0.61±1.47比1.16±1.62),差异有统计学意义(P<0.05).CMVA患者的TSH水平与LVEF和E/A比值相关,r值分别为0.205和0.305,P均<0.05;FT3水平与E/A比值相关,r=0.260,P<0.05.结论CMVA患者SCH影响了心脏的射血功能,参与了CMVA的发生和发展,其机制可能与脂质代谢有关.
Objective To explore the relationship between subclinical hypothyroidism(SCH)and cardiac function in patients with coronary microvascular angina(CMVA).Methods A total of 165 patients with CMVA from our hospital were randomly selected as CMVA group and 116 healthy people were selected as control group.The CMVA group was divided into normal thyroid function group and SCH group.Chemoluminescence immunifaction was used to determin the thyroid hormone and biochemical parameters.The cardiac function was evaluated by ultrasonography.Results The incidence of SCH and the positive rate of TPOAb were significantly higher in CMVA group than that in control group(29.7%vs.16.4%,26.1%vs.18.1%;P<0.05).There were different levels of TC,TG.HDL-C,LDL-C.CRP,UA.ApoB and E/A between the two groups.with statistically significant differences[TC:(5.25±1.26)mmol/L vs.(4.53±0.65)mmol/L;TG:(1.33±0.67)mmol/L vs.(1.02±0.31)mmol/L;HDL-C:(1.18±0.28)mmol/L vs.(1.56±0.33)mmol/L;LDL-C:(3.25±0.83)mmol/L vs.(3.02+0.18)mmol/L;CRP:(3.21±0.55)mg/L vs.(2.83±0.33)mg/L;UA:(357±72)mmol/L vs.(268±81)mmol/L;ApoB(1.17+0.30)g/L vs.(0.86±0.27)g/L;E/A:(0.78±1.54)vs.(1.15±1.43);all P<0.05].SCH group showed a lower rate of E/A than that in the normal thyroid function group with a statistically significant difference(0.61±1.47 vs.1.16±1.62.P<0.05).Univariate correlation analysis showed that TSH in CMVA group was correlated with LVEF and E/A and the r values were 0.205 and 0.305,respectively(both P<0.05);FT3 was correlated with E/A(r=0.260.P<0.05).Conclusion SCH ffects the cardiac function in patients with CMVA and contributes to the development of CMVA,of which the pathogenesis may be involved in lipide metabolism.
作者
王云英
孟竹
马红
陈爱芳
WANG Yun-ying;MENG Zhu;MA Hong;CHEN Ai-fang(Department of Medical Genetics Centralabi,Affiliated Qingdao Municipal Hospital of Qingdao University Medical College,Qingdao 266071,China;Health Care Department,Affiliated Qingdao Municipal Hospital of Qingdao University Medical College,Qingdao 266071,China;Ultrasound Diagnosis Department,Affiliated Qingdao Municipal Hospital of Qingdao University Medical College,Qingdao 266071,China)
出处
《中国心血管病研究》
CAS
2020年第9期793-796,801,共5页
Chinese Journal of Cardiovascular Research
作者简介
通信作者:陈爱芳,E-mail:cafl121@163.com。
