摘要
目的分析冠心病(coronary heart disease,CHD)患者甲状腺激素敏感性与心律失常风险之间的关系。方法2023年1月—2023年9月期间,选取CHD患者385例,按照有无发生心律失常分为心律失常组121例和非心律失常组264例,比较两组甲状腺激素敏感性,并分析甲状腺激素敏感性与心律失常风险的相关性,及其对心律失常风险的预测价值。结果与非心律失常组比较,心律失常组甲状腺反馈分位数指数(thyroid feedback quantile index,TFQI)、参数甲状腺反馈分位数指数(parameter thyroid feedback quantile index,PTFQI)、促甲状腺素甲状腺素抵抗指数(TT4RI)、促甲状腺素指数(thyroid stimulating hormone index,TSHI)更低(P<0.05),心律失常组游离三碘甲状腺原氨酸/游离甲状腺激素(FT3/FT4)更高(P<0.05)。经Spearman分析,TFQI、PTFQI、TT4RI、TSHI与心律失常呈负相关(P<0.05),FT3/FT4与心律失常呈正相关(P<0.05)。经二元logistic回归分析,高TT4RI、高TSHI是CHD患者心律失常的保护因素(P<0.05),FT3/FT4是CHD患者心律失常的危险因素(P<0.05)。联合=TFQI+(-1.563/-2.384)*PTFQI+(-0.152/-2.384)*TT4RI+(-2.027/-2.384)*TSHI+(9.820/-2.384)*FT3/FT4,受试者工作特征(receiver operating characteristic,ROC)曲线分析显示,TFQI、PTFQI、TT4RI、TSHI、FT3/FT4、联合预测CHD患者心律失常的AUC分别为0.681、0.681、0.748、0.695、0.744、0.862,在最佳临界值对应的敏感度、特异度分别为:TFQI为66.1%、70.5%,PTFQI为68.6%、68.2%,TT4RI为100.0%、50.0%,TSHI为90.1%、44.7%,FT3/FT4为49.6%、100.0%,联合为66.1%、94.3%。结论CHD甲状腺激素敏感性TFQI、PTFQI、TT4RI、TSHI、FT3/FT4与心律失常风险密切相关,且联合对CHD患者的心律失常风险具有较高的预测价值。
Objective To analyze the relationship between thyroid hormone sensitivity and the risk of arrhythmia in patients with coronary heart disease(CHD).Methods From January 2023 to September 2023,385 CHD patients were selected and divided into an arrhythmia group of 121 cases and a non arrhythmia group of 264 cases based on the occurrence of arrhythmia.The thyroid hormone sensitivity of the two groups was compared,and the correlation between thyroid hormone sensitivity and arrhythmia risk was analyzed,as well as its predictive value for arrhythmia risk.Results Compared with the non arrhythmia group,the thyroid feedback quantile index(TFQI),parameter thyroid feedback quantile index(PTFQI),thyroid stimulating hormone resistance index(TT4RI),and thyroid stimulating hormone index(TSHI)were than those lower in the arrhythmia group(P<0.05),while the free triiodothyronine/free thyroid hormone(FT3/FT4)were higher than those in the arrhythmia group(P<0.05).According to Spearman analysis,TFQI,PTFQI,TT4RI,TSHI were negatively correlated with arrhythmia(P<0.05),while FT3/FT4 was positively correlated with arrhythmia(P<0.05).Binary logistic regression analysis showed that high TT4RI and high TSHI were protective factors for arrhythmia in CHD patients(P<0.05),while FT3/FT4 was a risk factor for arrhythmia in CHD patients(P<0.05).Combined=TFQI+(-1.563-2.384)*PTFQI+(-0.152/-2.384)*TT4RI+(-2.027/-2.384)*TSHI+(9.820/-2.384)*FT3/FT4.receiver operating curve(ROC)curve analysis showed that TFQI,PTFQI,TT4RI,TSHI,FT3/FT4,and the AUC for predicting arrhythmia in CHD patients were 0.681,0.681,0.748,0.695,0.744,and 0.862,respectively.The sensitivity and specificity corresponding to the optimal critical values were:TFQI was 66.1%,70.5%,PTFQI was 68.5%,68.2%,TT4RI was 100.0%,50.0%,TSHI was 90.1%,44.7%,FT3/FT4 was 49.6%,100.0%,and combined was 66.1%,94.3%.Conclusion The sensitivity of CHD thyroid hormones to TFQI,PTFQI,TT4RI,TSHI,FT3/FT4 is closely related to the risk of arrhythmia,and the combination has high predictive value for the risk of arrhythmia in CHD patients.
作者
郁冲
张月婷
刘豪
YU Chong;ZHANG Yue-ting;LIU Hao(Department of Cardiology,Zhumadian Central Hospital Zhumadian,Henan 463000,China)
出处
《医药论坛杂志》
2024年第20期2188-2192,共5页
Journal of Medical Forum
关键词
冠心病
心律失常
甲状腺激素
促甲状腺素
预测价值
Coronary heart disease
Arrhythmias
Thyroid hormone
Thyroid stimulating hormone
Predictive value
