冠心病合并甲减患者基础代谢指标及心脏功能的变化研究

Study on the changes of basic metabolic markers and cardiac function in patients with coronary heart disease combined with hypothyroidism

目的:研究冠心病合并甲状腺功能减退(甲减)患者基础代谢率(basal metabolic rate,BMR)及心脏功能的变化。方法:临床纳入本院2013年5月至2014年10月收治的90例冠心病合并甲减患者为研究组,另纳入同期本院收治的单纯冠心病患者90例为对照组,对比两组患者的甲状腺功能、血脂水平、心功能情况以及BMR。结果:研究组患者TSH水平高于对照组,而FT3、FT4及BMR低于对照组(P<0.05)。两组HDL-C水平无显著性差异(P>0.05);研究组患者TC、TG以及LDLC水平均显著高于对照组(P<0.05)。两组患者E/A对比无差异(P>0.05);研究组LVEF低于对照组(P<0.05),LVMI与LVDd则高于对照组(P<0.05)。结论:冠心病合并甲减患者的血脂代谢及心功能状况显著异于单纯冠心病患者。对于甲减患者应进行适当干预,以减少其发生心血管事件的风险。

Objective To study the changes of basic metabolic rate （ BMR） and cardiac function in patients with coronary heartdisease combined with hypothyroidism. Methods：90 cases of coronary heart disease combined with hypothyroidism patients in our hospitalfrom May 2013 to October 2014 were selected as the study group,90 cases of the same simple coronary heart disease patients inour hospital were selected as control group, the thyroid function, blood lipids, heart function and BMR in the patients of the two groupswere compared. Results：The level of TSH in the study group was higher than that in the control group,while FT3,FT4 and BMR werelower than those in the control group （P 〈 0 . 0 5 ）. There was no significant difference in HDL-C levels between the two groups （P 〉0. 0 5 ）. The levels of TC , TG and LDL-C in the study group were significantly higher than those in the control group（ P 〈 0. 0 5 ）. Therewere no differences in E /A between the two groups （P 〉 0. 0 5 ）. LVEF in the study group was lower than that in the control group （P 〈0 .0 5 ） , while the LVDd and LVMI were higher than those in the control group （ P 〈 0 .0 5 ） . Conclusion：Lipid metabolism and cardiacfunction in patients with coronary heart disease combined with hypothyroidism is significantly different from simple coronary heart diseasepatients. In order to reduce the risk of cardiovascular events, appropriate intervention should be carried out for patients with hypothyroidism.