CAJ | 학술논문

目的：研究经皮冠状动脉介入术（PCI）手术患者血清促甲状腺激素（TSH）水平与心血管疾病严重程度的相关性。方法初次入组1122名行 PCI 术患者，根据所设定的筛选标准最后入组1000名患者。根据 TSH检测结果，将人群分为正常组、亚临床甲状腺功能减退组（简称亚临床甲减组）和亚临床甲状腺功能亢进组（简称亚临床甲亢组）。将 Gensini 积分和患者是否接受支架治疗作为主要的临床终点事件，以 Gensini 积分＞50表示心血管疾病严重程度较高。结果正常人群组和亚临床甲减组中，Gensini 积分＞50的患者在两人群中的分布情况存在明显差异（P ＝0．003）。二元 Logistic 回归分析显示患者是否为亚临床甲减是心血管疾病严重程度较高（Gensini 积分＞50）的独立危险因素[OR ＝1．855，95％可信区间（CI）：1．244～2．766，P ＝0．002]。而在TSH 水平正常的人群中，Gensini 积分是否＞50以及患者行支架术的情况在各组中的分布均不存在明显差异。结论亚临床甲减是心血管疾病的危险因素。正常范围内 TSH 的改变与心血管疾病的相关性有待进一步研究。
목적：연구경피관상동맥개입술（PCI）수술환자혈청촉갑상선격소（TSH）수평여심혈관질병엄중정도적상관성。방법초차입조1122명행 PCI 술환자，근거소설정적사선표준최후입조1000명환자。근거 TSH검측결과，장인군분위정상조、아림상갑상선공능감퇴조（간칭아림상갑감조）화아림상갑상선공능항진조（간칭아림상갑항조）。장 Gensini 적분화환자시부접수지가치료작위주요적림상종점사건，이 Gensini 적분＞50표시심혈관질병엄중정도교고。결과정상인군조화아림상갑감조중，Gensini 적분＞50적환자재량인군중적분포정황존재명현차이（P ＝0．003）。이원 Logistic 회귀분석현시환자시부위아림상갑감시심혈관질병엄중정도교고（Gensini 적분＞50）적독립위험인소[OR ＝1．855，95％가신구간（CI）：1．244～2．766，P ＝0．002]。이재TSH 수평정상적인군중，Gensini 적분시부＞50이급환자행지가술적정황재각조중적분포균불존재명현차이。결론아림상갑감시심혈관질병적위험인소。정상범위내 TSH 적개변여심혈관질병적상관성유대진일보연구。
Objective To investigate the correlation between serum thyroid-stimulating hormone ( TSH ) concentrations and cardiovascular severity in patients undergoing percutaneous coronary intervention (PCI).Methods Of 1 122 patients undergoing PCI, 1 000 who met inclusion criteria were classified into 3 groups according to serum TSH concentrations: normal,subclinical hypothyroidism and subclinical hyperthyroidism groups.The main outcomes were Gensini score with Gensini scores >50 defined as high cardiac risk and the percentage undergoing stent implantation. Results The percentages of patients with Gensini scores >50 differed significantly in normal and subclinical hypothyroidism groups (P =0.003).Binary Logistic regression analysis showed that subclinical hypothyroidism was an independent risk factor for cardiovascular disease [odds ratio (OR) =1.855, 95% confidence interval (CI): 1.244-2.766, P =0.002].In contrast,Gensini score >50 and stent implantation did not correlate with TSH concentration in normal group.Conclusions Subclinical hypothyroidism is a risk factor for cardiovascular disease in patients undergoing PCI.The correlation between normal TSH concentrations and cardiovascular disease requires further investigation.