甲状腺过氧化物酶抗体与冠心病相关性研究

Clinical study of correlation between thyroid peroxidase antibody and coronary heart disease

目的探讨甲状腺过氧化物酶抗体(TPO-Ab)与冠心病的相关性。方法选择浙江大学医学院附属第二医院(下称浙医二院)及杭州市中医院因胸闷或胸痛不适入院行冠状动脉造影检查,同时测定甲状腺功能及自身抗体滴度的患者485例(浙医二院425例,杭州市中医院60例)。根据TPO-Ab滴度检测结果,将患者分成TPO-Ab滴度增高(TPO-Ab+组)和TPO-Ab滴度正常(TPO-Ab-组)。采用Gensini积分评价冠状动脉病变严重程度。使用Spearman秩相关和多元线性回归分析TPO-Ab滴度与Gensini积分的相关性。结果 TPO-Ab+组患者53例,冠状动脉造影结果提示冠状动脉粥样硬化24例,冠心病28例,冠状动脉未见明显狭窄1例;TPO-Ab-组患者432例,冠状动脉造影结果提示冠状动脉粥样硬化189例,冠心病165例,冠状动脉未见明显狭窄78例,两组差异有统计学意义(P<0.05)。TPO-Ab+组Gensini积分[(38.65±28.82)分]高于TPO-Ab-组[(22.53±20.97)分],差异有统计学意义(U=3.951,P<0.05);Spearman秩相关分析提示TPO-Ab滴度与Ge ns ini积分呈正相关(r=0.197,P<0.01);多元线性回归分析提示TPO-Ab滴度与Ge ns ini积分呈正相关(r=0.015,P<0.05)。结论 TPO-Ab滴度增高与冠心病及其严重性相关。

Objective To investigate the correlation between thyroid peroxidase antibody （TPO-Ab） and coronary heart disease. Methods 485patients underwent coronary angiography for chest distress or chest pain and examination of thyroid function and autoantibodies were enrolled. They were divided into high TPO-Ab group and normal TPO-Ab group. Gensini score was calculated based on coronary angiography. The Spearman rank correlation and multiple linear regression analysis were performed to determine the correlation between TPO-Ab and Gensini score. Results 53 cases had high TPO-Ab. Of them, 24 cases were identified as coronary atherosclerosis, 28 cases coronary heart disease based on coronary angiography and 1 case had no obvious coronary stenosis. 432 cases had normal TPO-Ab. Of them, 189 cases were identified as coronary atherosclerosis, 165 cases coronary heart disease, and 78 cases had no obvious coronary stenosis. There was a significant difference between the two groups （P〈0.05）. Gensini score was significantly higher in high TPO-Ab group than in normal TPO-Ab group（38.65 ± 28.82 vs 22.53 ± 20.97, U = 3.951, P〈0.05）. Spearman rank correlation analysis showed that the TPO-Ab was positively correlated with Gensini score （r = 0.197, P〈0.01）. Multiple linear regression analysis showed that TPO-Ab was related to Gensini score （r = 0.015, P〈0.05）. Conclusion The increase of TPO-Ab is related to coronary heart disease and its severity.