CAJ | 학술논문

目的探讨甲状腺激素水平与冠心病及其严重性的关系.方法冠心病患者158例,根据选择性冠状动脉造影证实冠脉病变狭窄程度,将其分为冠脉狭窄组60例和冠脉无狭窄组(对照组)98例,再将冠脉狭窄组按狭窄累及范围分为单支病变组30例、双支病变组15例和多支(3支以上)病变组15例.采用电化学发光法检测游离三碘甲腺原氨酸(fT3)、游离甲状腺素(fT4)和促甲状腺激素(TSH)水平;采用胆固醇氧化酶法测定高密度脂蛋白胆固醇(HDL-C)、总胆固醇(TC)等指标.采用Gensini评分来评价受试者冠脉狭窄程度.结果与对照组比较,冠脉狭窄的双支病变组和多支病变组患者fT3水平显著降低(t=1.947、6.415,P均＜0.05),冠脉狭窄单支病变组fT4水平显著升高(t=3.026,P＜0.05).采用Logistic回归分析发现,fT3是冠心病的独立危险因素.以Gensini评分为因变量进行多元线性回归分析发现,fT3与Gensini评分呈负相关,fT3每降低0.234 pmol/L,Gensini评分升高1分.结论 fT3水平在冠状动脉狭窄患者中显著降低,并且与冠心病的严重程度密切相关,是冠心病的独立危险因素;fT3每降低0.234 pmol/L,Gensini评分升高1分,可以作为冠心病风险增加的敏感指标.
목적 탐토갑상선격소수평여관심병급기엄중성적관계.방법 관심병환자158례,근거선택성관상동맥조영증실관맥병변협착정도,장기분위관맥협착조60례화관맥무협착조(대조조)98례,재장관맥협착조안협착루급범위분위단지병변조30례、쌍지병변조15례화다지(3지이상)병변조15례.채용전화학발광법검측유리삼전갑선원안산(fT3)、유리갑상선소(fT4)화촉갑상선격소(TSH)수평;채용담고순양화매법측정고밀도지단백담고순(HDL-C)、총담고순(TC)등지표.채용Gensini평분래평개수시자관맥협착정도.결과 여대조조비교,관맥협착적쌍지병변조화다지병변조환자fT3수평현저강저(t=1.947、6.415,P균＜0.05),관맥협착단지병변조fT4수평현저승고(t=3.026,P＜0.05).채용Logistic회귀분석발현,fT3시관심병적독립위험인소.이Gensini평분위인변량진행다원선성회귀분석발현,fT3여Gensini평분정부상관,fT3매강저0.234 pmol/L,Gensini평분승고1분.결론 fT3수평재관상동맥협착환자중현저강저,병차여관심병적엄중정도밀절상관,시관심병적독립위험인소;fT3매강저0.234 pmol/L,Gensini평분승고1분,가이작위관심병풍험증가적민감지표.
Objective To explore the correlation between thyroxine hormone and the severity of coronary artery disease (CAD).Methods 158 patients with coronary adisease were entered consecutively into the study.They were separated into control group (absence of CAD,n=98)and CAD group (presence of CAD,n=60).Based on the number of vessel disease,CAD group was further divided into three sub-groups:single-vessel CAD subgroup (n=30),bi-vessel CAD subgroup (n=15) and multi-vessel CAD subgroup (n=15).Serum free triiodothyronine (fT3),free thyroxine (fT4),thyroid stimulating hormone (TSH) were tested by electrochemiluminescence; high density lipoprotein cholesterol (HDL-C) and total cholesterol (TC) weremeasured by cholesterol oxidase method; and Gensini scoring system was used to evaluate the degree of coronary artery stenosis.Results The levels of fT3 in both bi-vessel CAD and multi-vessel subgroups were higher than those in control group (t=1.947,6.415,both P＜0.05).And the level of fT4 in multi-vessel subgroup was also higher than that in control group (t=3.026,P＜0.05).fT3 was an independent risk factor of CAD using Logistic regression model.In addition,fT3 was negatively correlated with Gensini scoring inmultiple linear regressions.Gensini scores would increase by 1 as long as the level oft fT3 decreases 0.234 pmol/L.Conclusions fT3 level decreased in patients with CAD,and correlated with the severity of CAD.Gensiniscores would increase 1 as long as fT3 decreases 0.234 pmol/L,which could be supposed as a sensitive predictor of CAD.