甲状腺功能检测在心血管疾病老年患者中的应用

The application of thyroid function tests in elderly patients with cardiovascular disease

目的探讨心血管疾病老年患者中甲状腺功能检测的临床应用价值。方法选取2013年12月至2014年11月在重庆某院初步诊断为心血管疾病的60~89岁患者845例作为病例组。另选取同期该院体检中心相同年龄段健康体检者200位作为对照组。检测两组甲状腺激素水平。结果病例组甲状腺功能测定异常类型,在不同年龄阶段分布中差异有统计学意义(P<0.05)。与对照组相比,病例组甲状腺功能异常检出率显著升高,差异有统计学意义(P<0.05)。对照组与病例组的促甲状腺激素(TSH)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)浓度比较,差异均有统计学意义(P<0.01)。与对照组相比,冠心病、心房颤动的TSH浓度显著升高,心律失常的TSH浓度显著降低,高血压和冠心病的FT3、FT4浓度显著升高,心律失常的FT3浓度显著升高,心房颤动的FT3和FT4浓度显著降低,差异均有统计学意义(P<0.01)。结论甲状腺功能异常在心血管疾病老年患者中有较高的检出率,各种异常均可能对心血管系统产生影响。积极控制异常的甲状腺激素水平,能够显著改善心功能。因此在心血管疾病老年患者中,常规普查甲状腺功能有利于心血管疾病的诊治。

Objective To investigate the clinical application value of thyroid examination for elderly patients with cardiovascular disease.Methods 845 cases from 60 to 89 years old,who were initially diagnosed as cardiovascular disease in a hospital in Chongqing from December 2013 to November 2014,were selected as the case group.Another 200 healthy persons in the same age group who underwent the healthy assessment in the physical examination center of the hospital during the same period were selected as the control group.The levels of thyroid hormone were detected in two groups.Results The abnormal type of thyroid function in the case group had a statistically significant difference in different age distribution（P〈0.05）.The detection rate of thyroid dysfunction was significantly higher in the case group than that in the control group,and the difference was statistically significant（P〈0.05）.The differences of thyrotropin stimulating hormone（TSH）,free triiodothyronine（FT3）and free thyroxine（FT4）concentrations between the control group and the case group were statistically significant（P〈0.01）.In comparison with the results in the control group,the concentration of TSH in patients with coronary heart disease and atrial fibrillation increased significantly,the TSH concentration of patients with arrhythmia decreased significantly,the concentrations of FT3 and FT4 in patients with hypertension and coronary heart disease increased significantly,the FT3 concentration in patients with arrhythmia significantly increased,and the concentrations of FT3 and FT4 in patients with atrial fibrillation significantly decreased,and the differences were statistically significant（P〈0.01）.Conclusion The thyroid dysfunction has a high detection rate in elderly patients with cardiovascular disease,and all kinds of abnormalities may have an effect on the cardiovascular system.Thus,active control of the abnormal thyroid hormone value can significantly improve the patients′cardiac function.Therefore,for elderly patients with cardiovascular disease,routine screening of thyroid function is conducive to the diagnosis and treatment of their cardiovascular diseases.