老年心血管疾病住院患者低T3综合征临床研究

Clinical Research of Lower Triiodothyronine Syndrome in Elder Inpatients of Cardiovascular Disease

【目的】探讨低T 3综合征在老年心血管疾病患者中的发生率及其临床意义。【方法】选择本院2009至2012年收治的390例老年心血管病患者，年龄60～75岁，其中急性心肌梗死106例，稳定性心绞痛86例，高血压患者120例，扩张性心肌病30例，慢性心力衰竭48例。采用化学发光免疫分析法测定上述各种病人的甲状腺激素水平。【结果】研究对象低T 3综合征发生率分别为：急性心肌梗死23．6％（25／106），稳定性心绞痛4．7％（4／86），高血压12．5％（15／120），扩张性心肌病23．3％（7／30），慢性心力衰竭22．9％（11／48）。在老年心血管疾病患者中，心功能越差的患者T3、游离三碘甲状腺原氨酸（FT3）水平越低。【结论】低 T3综合征在老年急危重症心血管疾病中发生率相对较高。T3、FT3水平与患者疾病的严重程度相关，可作为判断疾病预后的客观指标之一。

[Objective] To assess the prevalence and clinical characteristics of low triiodothyronine syndrome in elder inpatients of cardiovascular disease .[Methods]During the period of 2009～2012 ,a total of 390 elders with cardiovascular diseases were recruited from cardiovascular and gereology departments .The etiologies were acute myocardial infarction （ n=106） ,stable angina pectoris （ n=86） ,hypertension （ n =120） ,dilated cardiomyopahty （n=30） and chronic heart failure （n=48） .And serum thyroid hormones were determined by chemiluminescent immunoassay .[Results]The preva‐lence of low triiodothyronine syndrome was 4 .6% in stable angina pectoris ,12 .5% in hypertension ,22 .9% in chronic heart failure ,23 .3% in dilated cardiomyopahty and 23 .6% in acute myocardial infarction patients .In cardiovascular disease elders ,the lower level of T3 or FT3 ,the worse heart functions .[Conclusion]The prevalence of low triiodothyronine syndrome is high in cardiovascular disease elders ,especially in acute and serious cardiovascular disease .The serum levels of serum triiodothyronine and free triiodothyronine are correlated with illness severity so that these two markers may be useful in evaluating illness prognosis .