尿清蛋白/肌酐比值评估冠心病患者伴甲状腺功能紊乱的价值

Value of urinary albumin/creatinine ratio for assessing coronary heart disease complicating thyroid dysfunction

目的探讨尿清蛋白(Alb)/肌酐(Cr)比值(ACR)在冠心病患者伴甲状腺功能紊乱诊断中的价值及与甲状腺功能各检测指标的相关性。方法收集2015年11月至2016年8月在该院确诊的863例冠心病患者尿ACR及甲状腺功能检测结果。依据美国美国肾脏病基金会和食品和药物管理局诊断标准将863例冠心病患者分为A组(ACR≤10.0mg/g·Cr)、B组(10.0mg/g·Cr<ACR≤30.0mg/g·Cr)、C组(30.0mg/g·Cr<ACR≤300mg/g·Cr)、D组(ACR>300mg/g·Cr);另根据甲状腺功能指标参考值将患者分为甲状腺功能结果正常组和异常组。结果 863例冠心病患者ACR与游离三碘甲状腺原氨酸(FT3)呈负相关(r=-0.297,P<0.05),与游离甲状腺素(FT4)呈正相关(r=0.172,P<0.05);各组间甲状腺功能异常率比较差异有统计学意义(χ2=33.533,P<0.05);ACR>10.0mg/g·Cr与ACR≤10.0mg/g·Cr患者甲状腺功能异常率比较差异有统计学意义(P<0.05),其危险度为2.083。结论 ACR可能是冠心病患者伴甲状腺功能紊乱的一个危险因素,当ACR>10.0mg/g·Cr时对冠心病患者监测甲状腺功能是必要的。

Objective To explore the value of urinary albumin/creatinine ratio（ACR）in coronary heart disease（CHD）complicating thyroid dysfunction and its correlation with the various detection indicators of thyroid function.Methods The results of urinary ACR and thyroid function detection in 863 patients with CHD in our hospital from November 2015 to August 2016 were collected.According to the standards of American National Kidney Foundation（NKF）and Food and Drug Administration（FDA）,863 CHD patients were divided into the group A（ACR≤10.0 mg/g·Cr）,B（10.0 mg/g·Cr〈ACR≤30.0 mg/g·Cr）,C（30.0mg/g·Cr〈ACR≤300mg/g·Cr）and D（ACR 〉300mg/g·Cr）.According to the reference values of thyroid functional indicators,these patients were divided into the thyroid function normal and abnormal groups.Results The ACR level was negatively correlated with the FT3 level in 863 CHD patients（r=-0.297,P〈0.05）,and was positively related with the FT4level（r=0.172,P〈0.05）.The abnormal rate of thyroid function had significantly statistical difference among four groups（χ^2=33.533,P〈0.05）.The abnormal rate of thyroid function had significantly statistical difference between the patients with ACR〉10.0mg/g·Cr and the patients with ACR≤10.0 mg/g·Cr,the difference was statistically significant（P〈0.05）,its risk degree was 2.083.Conclusion ACR is likely to be a risk factor for CHD patients complicated with thyroid dysfunction.It is necessary to monitor the thyroid function when ACR level〉10.0mg/g·Cr in CHD patients.