老年射血分数保留心力衰竭患者血清甲状腺激素水平变化及其意义

Clinical significance and variation of serum levels of thyroid hormones in elderly heart failure patients with preserved ejection fraction

目的分析老年射血分数保留心力衰竭患者的血清甲状腺激素水平及其与其他化验指标及超声心动图参数的关系。方法入选2013年12月至2014年12月在首都医科大学附属北京友谊医院医疗保健中心住院的175例老年患者,其中射血分数保留心力衰竭组(HFp EF组)患者100例,无心衰的其他疾病住院患者对照组75例,测定其血清中甲状腺激素[包括游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、总三碘甲状腺原氨酸(T3)、总甲状腺素(T4)、促甲状腺素(TSH)]水平、经胸超声心动图各项参数(包括二尖瓣舒张早期血流峰值速度(E)、二尖瓣环舒张早期运动速度(e')及E/e'比值等)、血清N端脑钠肽前体(NT-pro BNP)等指标,并进行统计分析。结果 HFp EF组患者T3、FT3水平低于对照组,NT-pro BNP水平高于对照组(P<0.05);HFp EF组患者T3、FT3水平与E/e'比值及NT-pro BNP水平呈负相关(P<0.05)。结论 T3、FT3与老年患者HFp EF的发生发展及严重程度相关。

Objective To assess the variation of semm levels of thyroid hormones in elderly patients suffering heart failure wi 出 ejection fraction （HFpEF） , and to explore the relationship between serum levels of thyroid hormones and data of other laboratory tests and echocar-diography. Methods A total of 175 patients （ ≥60 years old） admitted in this department during December 2013 to December 2014 were en-rolled in this study. They were divided into HFpEF group （ n = 100） and control group （ n = 75）. Serum levels of thyroid hormones [ free triiodo-thyronine （FT3 ） , free thyroxine （ FT4） , total triiodothyronine （T3） , total thyroxine （T4） , thyriod - stimulating hormone （TSH） ] , transthoracic echocardiographic parameters （including early diastolic peak mitral flow velocity （E） , velocity of mitral annulus early diastolic motion （e〇 , E/e ratio, etc. ） , N - terminal pro - brain natriuretic peptide （ NT - proBNP） levels were acquired and statistically analyzed. Results In comparison with control group, serum levels of T3 and FT3 were remarkably lower and level of NT - proBNP was remarkably higher in patients with HFpEF group （ P 〈 0. 05）. According to linear correlation analysis, serum levels of T3 and FT3 were negatively correlated with levels of E/e and NT - proBNP in patients with HFpEF group （ P 〈 0 .0 5 ） . Conclusion Serum levels of T3 and FT3 are correlated with the occurrence, development and severity of HFpEF in elderly patients.