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首页> 中文期刊> 《西安交通大学学报（医学版）》 >正常范围内低水平游离甲状腺素与冠脉病变及颈动脉硬化的关系

正常范围内低水平游离甲状腺素与冠脉病变及颈动脉硬化的关系

         
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Objective To investigate the association of low level of free thyroxin (FT4)within normal range with the severity of coronary artery disease (CAD)and carotid atherosclerosis.Methods We enrolled 312 consecutive patients who underwent coronary angiography (CAG)and divided them into CAD group (196 cases)and non-CAD group (116 cases)according to CAG results.We calculated Gensini score and divided CAD group into≤10 Gensini score group (n=65),10-30 Gensini score group (n=67)and ＞30 Gensini score group (n=64).Thyroid hormone level,carotid intima-media thickness (CIMT)and other clinical data were measured and compared between the groups,and the correlation analysis was used to find the relationship of FT4 level with Gensini score.By taking CIMT reference value of 0.9 mm as the standard,we divided the patients into thickened IMT group (IMT≥0.9 mm)and normal IMT group (IMT＜0.9 mm).Results The level of FT4 was significantly lower in CAD group and subgroups than in non-CAD group (P＜0.05).The level of FT4 was negatively correlated with Gensini score (P＜0.05).The levels of FT4 and TT4 were significantly lower in thickened CIMT group than in normal CIMT group (P＜0.05).Conclusion Low level of FT4 within normal range is significantly related to the severity of CAD,and low level of FT4 can be used as an independent risk factor for the severity of CAD.Low levels of FT4 and TT4 are significantly related to carotid atherosclerosis.%目的 探讨正常范围内低水平游离甲状腺素(FT4)与冠脉病变及颈动脉硬化的关系.方法 连续收集 312 例行冠脉造影术的患者,根据造影结果分为冠心病(CAD)组(196 例)和非冠心病(non-CAD)组(116 例),测定甲状腺激素水平、生化指标及颈动脉内中膜厚度(CIMT)等项目.计算 CAD 组 Gensini 积分,并根据 Gensini 积分分为低分(n=65)、中分(n=67)和高分(n=64)3 个亚组,分别比较各组间的基本资料,探讨正常范围内 FT4 水平与冠脉病变的关系;根据CIMT分为增厚组(IMT≥0.9 mm)和非增厚组(IMT＜0.9 mm),比较两组间FT4 水平.结果 ①CAD组的 FT4 水平显著低于non-CAD组(P＜0.05);②CAD组3 个亚组FT4 水平均显著低于non-CAD组(P＜0.05);③单因素与多因素分析均显示 FT4 水平与 Gensini积分显著负相关(P＜0.05);④CIMT增厚组 FT4、总 T4(TT4)水平显著低于非增厚组(P＜0.05).结论 正常范围内低水平 FT4 与冠脉病变密切相关,低水平 FT4 是冠脉病变的独立危险因素;正常范围内低水平 FT4、TT4 与颈动脉硬化密切相关.

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