甲亢合并急性冠脉综合征的临床及冠脉特点研究

Study on the Clinical and Coronary Features of Patients with Hyperthyroidism and Acute Coronary Syndrome

探讨甲亢合并急性冠脉综合征(ACS)患者的临床及冠状动脉病变特点。选取2010年1月至2013年6月于我院住院诊断的甲亢合并ACS患者(甲亢组)64例及甲状腺功能正常的ACS患者(对照组)56例,分析其临床及冠脉病变特点。甲亢组静息性心绞痛、高血压、糖尿病的发生率,纤维蛋白原(FIB)、氨基末端B型利钠肽前体(NT-proBNP)水平、零病变及冠状动脉痉挛比例明显高于对照组(P<0.05),低密度脂蛋白胆固醇(LDL-C)、总胆固醇(TC)水平明显低于对照组(P<0.05)。甲亢合并ACS患者常发生静息性心绞痛,冠心病危险因素与甲状腺功能正常患者有所不同,零病变及冠脉痉挛比例高,冠状动脉痉挛可能是其发生急性心肌缺血的重要机制。

To explore the clinical and coronary manifestation of patients with hyperthyroidism and acute coronary syndrome, 120 patients with acute coronary syndrome were divided into two groups according to thyroid state： hyperthyroidism group （n=64）, euthyroidism group （n=56）. The clinical records and angiographic images were analyzed. The rate of resting angina, hypertension and diabetes mellitus, the levels of FIB, NT-proBNP, the proportion of zero lesion and coronary spasm were significantly higher in hyperthyroidism group than those in control group （P〈0.05）, the levels of TC and LDL-C were lower in the former group （P〈0.05）. Patients with hyperthyroidism had high rate of resting angina, zero lesion and coronary spasm, different cardiovascular disease risk factor spectrum, coronary spasm might be an important mechanism of acute myocardial ischemia.