冠心病患者血脂和亚临床甲状腺功能减退的临床观察

The Clinical Observation of Blood Lipid Subclinical Hypothyrodism and Patients with CHD

目的:对冠心病患者血脂和亚临床甲状腺功能减退情况进行观察并作探讨。方法:应用生物化学法和化学发光免疫分析测定了156例CHD患者[其中51例稳定型心绞痛(SAP)、48例不稳定型心绞痛(UAP)和57例急性心肌梗死(AMI)患者]和60例正常对照组的血脂和血清甲状腺激素(TH),并进行了比较性分析。结果:156例CHD患者较60例正常对照组血清TC、TG、LDL-C和LP(a)水平明显增高(P<0.05～0.01),血清HDL-C无明显差异(P>0.05),而且随SAP、UAP和AMI患者血清TC、TG、HDL-C、LDL-C水平逐渐降低,AMI患者降低最为明显,而血清LP(a)增高最为明显。在TH分析中,156例CHD患者较60例正常对照组血清T3和FT3水平明显降低(P均<0.05),而血清T4、FT4和TSH水平无明显差异(P均>0.05)。而且随SAP、UAP和AMI患者血清T3和FT3水平逐渐降低(P<0.05～0.01),AMI患者降低最为明显(P<0.01)。结论:CHD患者血脂代谢紊乱。血脂TC、TG、LDL-C和LP(a)水平明显增高,而血清T3和FT3水平明显降低,均随着CHD的严重程度而降低,而血清LP(a)增高。AMI患者血清LP(a)水平增高最为明显,而血清T3和FT3水平降低最为明显。

Objective In order to explore the clinical observation of blood lipid subclinical hypothyrodism and patients with CHD. Methods The blood lipid [TC,TG,HDL-C,LDL-C and LP（a） ] （with biochemistry） and serum T3 ,T4 ,FT3 ,F4 and TSH （with chemiluminescenece immunoassay） levels were determined in 156 patients with CHD consists of 51 cases SAP,48 cases UAP and 57 cases AMI） and 60 normal controls, then followed with comparative analysis. Results The serum [ TC, TG, LDL-C and LP （a） ] levels in 156 patients with CHD showed significantly higher than those in controls （P 〈 0.05 - 0.01 ）. But the HDL-C levels proved no significant difference, and decreased gradually with SAP, UAP and AMI patients , the serum TC ,TG, HDL-C and LDL-C in patients with AMI were most significantly lower in patients with CHD, but the serum LP（a） levels indicated most markedly increased. In TH analysis, the serum T3 and FT3 levels in 156 patients with CHD showed apparently lower than those in controls （P 〈0.05） ,but the T4, FT4 and TSH levels expressed no significant difference （P 〉 0.05）, and were decreased with SAP, UAP and AMI patients （P 〈 0.05 -0.01 ） ,the serum T3 and FT3 levels in 156 patients with AMI presented metabolic disorder of blood lipid, most notable lower in patients with CHD（P 〈 0.01 ）. Conclusion CHD patients TC,TG, LDL-C and LP（a） levels occured significantly increased and ab- normal metabolism, but the serum T3 and FT3 levels showed significantly lower and decreased with severity pf CHD, but the serum LP （a） level remain increased. The serum LP （a） , T3 and FT3 levels in patients with AblI proved most higher and lower in patients with CHD.