绝经后女性不稳定性心绞痛患者甲状腺激素水平与冠状动脉狭窄程度的相关性分析

Association between serum level of thyroid hormones and severity of coronary artery stenosis in postmenopausal women with UAP

目的探讨绝经后女性不稳定性心绞痛(UAP)患者甲状腺激素水平与冠状动脉狭窄程度的关系。方法纳入甲状腺功能正常且经冠状动脉造影(CAG)检查的绝经后女性住院患者203例,其中UAP组105例,对照组(CAG检查阴性)98例。UAP组患者经Gensini评分评价后,分为轻中度狭窄35例和重度狭窄70例。分析血清促甲状腺激素、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)与UAP患者冠状动脉狭窄程度的关系。结果与对照组比较,UAP组患者年龄更高,合并吸烟、高血压、糖尿病、慢性肾脏病的比例更高(P<0.05),且收缩压和血清脂蛋白(a)水平更高(P<0.05),FT3、FT4水平更低(P<0.05)。与轻中度狭窄患者比较,重度狭窄患者血清TC、LDL-C水平更高(P<0.05),FT3水平更低(P<0.05)。相关分析显示,FT3与LDL-C水平呈负相关(r=-0.217,P=0.026),二元多因素logistic回归分析显示,低FT3水平与冠状动脉狭窄程度显著相关(B=-2.388,OR=0.092,95%CI:0.026~0.326,P=0.000)。结论绝经后女性UAP患者低FT3水平与冠状动脉狭窄的严重程度密切相关。

Objective To study the association between serum level of thyroid hormones and severity of coronary artery stenosis（CAS）in postmenopausal women with unstable angina pectoris（UAP）.Methods Two hundred and three postmenopausal women with normal thyroid function were divided into UAP group（n=105）and control group（n=98）.The patients in UAP group were further divided into mild-moderate CAS（n=35）and severe CAS（n=70）according to their Gensini score.The association between serum levels of TSH,FT3,FT4 and severity of CAS in UAP group was analyzed.Results The age was older,the history of smoking was longer,the incidence of hypertension,DM,chronic renal disease was higher,the systolic pressure and serum Lp（a）level were higher while that of FT3 and FT4 was lower in UAP group than in control group（P〈0.05）.The serum level of TC and LDL-C was higher while that of FT3 was lower in severe CAS than in mild-moderate CAS（P〈0.05）.Pearson correlation analysis showed that the serum level of FT3 was negatively associated with that of LDL-C（r=-0.217,P=0.026）.Multivariate logistic regression analysis revealed that the low serum level of FT3 was closely associated with the severity of CAS（B=-2.388,OR=0.092,95%CI：0.026-0.326,P=0.000）.ConclusionThe low serum level of FT3 is closely associated with the severity of CAS in postmenopausal women with UAP.