CAJ | 학술논문

目的探讨年龄增长对正常甲状腺激素水平与冠心病关系的影响. 方法收集2013年1月至2014年6月于我院行选择性冠状动脉造影、且甲状腺功能正常者共1163例,根据年龄将入选者分为中青年组(年龄＜60岁)602例和老年组(年龄≥60岁)561例,各组再根据冠状动脉造影结果分为冠心病组和非冠心病组.测定患者身高、体质量、血脂、空腹血糖、糖化血红蛋白及游离三碘甲状腺原氨酸(FT3)、游离甲状腺激素(FT4)、促甲状腺激素(TSH). 结果 (1)中青年组602患者中,检出冠心病309例(51.3％);同组冠心病组与非冠心病组FT3[(5.3±0.6)mmol/L比(5.3±0.5)mmol/L]、FT4[(11.8±1.9) mmol/L比(11.8±1.8) mmol/L]、TSH [2.0±1.1] mIU/L比(2.0±1.0) mIU/L]水平比较,差异均无统计学意义(均P＞0.05);(2)老年组561例患者中,检出冠心病357例(63.6％);同组冠心病组与非冠心病组FT3水平比较[(5.1±o.6)mmol/L比(5.2±0.5)mmol/L],差异有统计学意义(P＜0.01);(3) Logistic回归分析显示,FT3为老年冠心病的独立影响因素(OR=0.564,P＜0.01). 结论正常甲状腺激素水平与冠心病的关系因年龄增长而变化,甲状腺激素水平与中青年冠心病无显著关系,老年人随着FT3水平降低可能增加冠心病的患病风险.
목적 탐토년령증장대정상갑상선격소수평여관심병관계적영향. 방법 수집2013년1월지2014년6월우아원행선택성관상동맥조영、차갑상선공능정상자공1163례,근거년령장입선자분위중청년조(년령＜60세)602례화노년조(년령≥60세)561례,각조재근거관상동맥조영결과분위관심병조화비관심병조.측정환자신고、체질량、혈지、공복혈당、당화혈홍단백급유리삼전갑상선원안산(FT3)、유리갑상선격소(FT4)、촉갑상선격소(TSH). 결과 (1)중청년조602환자중,검출관심병309례(51.3％);동조관심병조여비관심병조FT3[(5.3±0.6)mmol/L비(5.3±0.5)mmol/L]、FT4[(11.8±1.9) mmol/L비(11.8±1.8) mmol/L]、TSH [2.0±1.1] mIU/L비(2.0±1.0) mIU/L]수평비교,차이균무통계학의의(균P＞0.05);(2)노년조561례환자중,검출관심병357례(63.6％);동조관심병조여비관심병조FT3수평비교[(5.1±o.6)mmol/L비(5.2±0.5)mmol/L],차이유통계학의의(P＜0.01);(3) Logistic회귀분석현시,FT3위노년관심병적독립영향인소(OR=0.564,P＜0.01). 결론 정상갑상선격소수평여관심병적관계인년령증장이변화,갑상선격소수평여중청년관심병무현저관계,노년인수착FT3수평강저가능증가관심병적환병풍험.
Objective To investigate the effect of age on the association between normal thyroid hormone level and coronary artery disease (CAD).Methods A total of 1163 euthyroid patients undergoing coronary angiography (CAG) from January 2013 to June 2014 were enrolled and categorized into 2 groups:the young and middle-aged group (＜60 years,n=602) and the elderly group (≥60 years,n=561),and each group was sub grouped into the CAD and non-CAD group according to CAG.Height,body weight,and levels of serum lipid,fasting blood glucose,glycosylated hemoglobin,free triiodothyronine (FT3),free thyroxine (FT4) and thyroid-stimulating hormone (TSH) were measured.Results In the youth and middle-aged group,309 patients (51.3％) were diagnosed as CAD,and there was no significant difference in the levels of FT3,FT4 and TSH between CAD and non-CAD patients [(5.3±0.6)mmol/L vs.(5.3±0.5)mmol/L,(11.8 ±1.9)mmol/L vs.(11.8±1.8) mmol/L,(2.0±1.1) mIU/L vs.(2.0±1.0)mIU/L,all P＞0.05].In the elderly group,357 patients (63.6％) were diagnosed as CAD,and the FT3 level was lower in the CAD patients than in the non-CAD patients[(5.1±0.6)mmol/L vs.(5.2±0.5) mmol/L,P＜0.01].Logistic regression demonstrated that FT3 was an independent influencing factor for CAD in elderly patients (OR=0.564,P＜0.01).Conclusions The association between normal thyroid hormones levels and CAD varies along with age.Thyroid hormones have no relationships with CAD in the young and middle-aged people.The decline of FT3 level may increase the risk of CAD in the elderly.