CAJ | 학술논문

目的：探讨冠心病患者亚临床甲状腺功能减退症（亚临床甲减）与冠状动脉狭窄程度的相关性。方法选择2011年1月—2012年12月于广西医科大学第四附属医院就诊，并行冠状动脉造影（CAG）或经皮冠状动脉介入治疗（PCI）的患者350例。根据冠状动脉造影的结果分为对照组（冠脉造影正常）90例，冠心病组260例，检测FT3、FT4和sTSH，收集其一般临床资料及冠状动脉造影结果，冠心病患者冠状动脉狭窄程度依据Gensini 评分标准进行评分，按Gensini 积分分成3组（Gensini 积分＜30分组、30～60分组、＞60分组）。比较对照组及冠心病组亚临床甲减的发病率及不同Gensini 积分时冠心病亚临床甲减的发病率及sTSH 水平；行多因素相关性分析分析亚临床甲减与冠心病Gensini 的相关性。结果（1）冠心病组亚临床甲减发病率（20．77％）高于正常对照组（12．22％）（P ＜0．05）；（2）冠心病Gensini 积分＞60分组亚临床甲减发病率为26．83％，显著高于Gensini 积分＜30分组（17．58％）和30～60分组（18．39％），P ＜0．05。sTSH 水平Gensini 积分＞60分组高于Gensini 积分＜30分组和30～60分组（P ＜0．01）；（3）亚临床甲减者发生冠心病的危险度是甲状腺功能正常者的2．53倍，冠脉病变Gensini积分与sTSH 呈正相关（r ＝0．548，P ＜0．05）。结论亚临床甲减是冠心病的危险因素之一，且与冠状动脉狭窄程度相关。
목적：탐토관심병환자아림상갑상선공능감퇴증（아림상갑감）여관상동맥협착정도적상관성。방법선택2011년1월—2012년12월우엄서의과대학제사부속의원취진，병행관상동맥조영（CAG）혹경피관상동맥개입치료（PCI）적환자350례。근거관상동맥조영적결과분위대조조（관맥조영정상）90례，관심병조260례，검측FT3、FT4화sTSH，수집기일반림상자료급관상동맥조영결과，관심병환자관상동맥협착정도의거Gensini 평분표준진행평분，안Gensini 적분분성3조（Gensini 적분＜30분조、30～60분조、＞60분조）。비교대조조급관심병조아림상갑감적발병솔급불동Gensini 적분시관심병아림상갑감적발병솔급sTSH 수평；행다인소상관성분석분석아림상갑감여관심병Gensini 적상관성。결과（1）관심병조아림상갑감발병솔（20．77％）고우정상대조조（12．22％）（P ＜0．05）；（2）관심병Gensini 적분＞60분조아림상갑감발병솔위26．83％，현저고우Gensini 적분＜30분조（17．58％）화30～60분조（18．39％），P ＜0．05。sTSH 수평Gensini 적분＞60분조고우Gensini 적분＜30분조화30～60분조（P ＜0．01）；（3）아림상갑감자발생관심병적위험도시갑상선공능정상자적2．53배，관맥병변Gensini적분여sTSH 정정상관（r ＝0．548，P ＜0．05）。결론아림상갑감시관심병적위험인소지일，차여관상동맥협착정도상관。
Objective To explore the relationship between subclinical hypothyroidism and severity of coronary artery steno-sis in patients with coronary artery disease.Methods We studied 350 patients who underwent elective coronary angiography or Percutaneous Coronary Intervention.Patients were divided into two groups:normal coronary artery group( control group, n=90) and coronary artery heart disease group (CHD group, n=260).Serum levels of free triiodothyronine (FT3), free thyroxine ( FT4) and thyrotropin ( thyroid stimulating hormone, TSH) were tested.General clinical data and results of cor-onary angiography were collected.Gensini score was determined based on the degree of coronary artery stenosis in patients with coronary artery disease.The patients were further divided into three groups according to Gensini score: <30 group, 30-60 group, and >60 group.Incidence of subclinical hypothyroidism was compared between coronary heart disease group and control group.Correlation of different Gensini score in patients with coronary heart disease and level of sTSH insubclinical hypothyroidism was studied.Multi-factor correlation analysis was performed.Results (1) The prevalence of subclinical hypothyroidism in CHD group (20.77%) was higher than that in control group (12.22%) (P<0.05).(2) The prevalence of subclinical hypothyroidism in Gensini's score>60 group (26.83%) was higher than that in Gensini’ s score<30 group(17.58%)and Gensini’s score 30-60 group (18.39%)(P<0.05).(3)The concentration of sTSH in Gensini’s score>60 group was higher than that in Gensini’s score<30 group(17.58%)and Gensini’s score between 30 to 60 group(18.39%)(P<0.05).(4)Logistic regression analysis revealed that the incidence of CHD in subclinical hy-pothyroidism patients was 2.53 times than euthyroidism patients.Gensini's score had a significant correlation with TSH level (r=0.548,P<0.05).Conclusion Subclinical hypothyroidism is one of the risk factors for coronary artery disease and has positive relationship with severity of coronary artery stenosis in patients with coronary artery disease.