2型糖尿病并冠心病患者游离三碘甲状腺原氨酸和促甲状腺激素水平变化及其临床意义

Changes and Clinical Significance of FT3 and TSH in Type 2 Diabetes Mellitus Patients Complicated with Coronary Heart Disease

目的分析2型糖尿病并冠心病患者游离三碘甲状腺原氨酸(FT3)和促甲状腺激素(TSH)水平变化及其临床意义。方法选取中国人民解放军第421医院2012年10月—2015年10月收治的2型糖尿病患者56例,其中并发冠心病患者35例(冠心病组)、未并发冠心病患者21例(非冠心病组);另选取同期门诊体检健康者21例作为对照组。比较冠心病组和非冠心病患者一般资料,3组受试者FT3和TSH水平;2型糖尿病患者并发冠心病的影响因素分析采用多因素Logistic回归分析。结果冠心病和非冠心病患者性别、年龄、吸烟史、体质指数、冠心病家族史、高血压发生率、高脂血症发生率比较,差异无统计学意义(P>0.05)。非冠心病组和冠心病组患者FT3水平低于对照组,TSH水平高于对照组(P<0.05);冠心病组患者FT3水平低于非冠心病组,TSH水平高于非冠心病组(P<0.05)。多因素Logistic回归分析结果显示,FT3是2型糖尿病患者并发冠心病的保护因素[OR=0.322,95%CI(0.109,0.950)],TSH是2型糖尿病患者并发冠心病的危险因素[OR=2.234,95%CI(1.061,4.706),P<0.05]。结论 2型糖尿病并冠心病患者FT3水平降低、TSH水平升高,且二者均是2型糖尿病患者并发冠心病的影响因素。

Objective To analyze the changes and clinical significance of FT3 and TSH in type 2 diabetes mellitus patients complicated with coronary heart disease.Methods A total of 56 patients with type 2 diabetes mellitus were selected in the 421st Hospital of the Chinese People's Liberation Army from October 2012 to October 2015,thereinto 35 cases complicated with coronary heart disease were served as A group,the other 21 cases did not complicate with coronary heart disease were served as B group;meanwhile 21 healthy people admitted to this hospital for physical examination were selected as control group.General information was compared between A group and B group,FT3 and TSH were compared in control group,A group and B group;multivariate Logistic regression analysis was used to analyze the influencing factors of coronary heart disease in patients with type 2 diabetes mellitus.Results No statistically significant differences of gender,age,smoking history,BMI,family history of coronary heart disease,incidence of hypertension or hyperlipidaemia was found between A group and B group(P>0.05).FT3 in A group and B group was statistically significantly lower than that in control group,respectively,while TSH in A group and B group was statistically significantly higher than that in control group,respectively(P<0.05);FT3 in A group was statistically significantly lower than that in B group,while TSH in A group was statistically significantly higher than that in B group(P<0.05).Multivariate Logistic regression analysis results showed that,FT3 was the protective factor of coronary heart disease in patients with type 2 diabetes mellitus〔OR=0.322,95%CI(0.109,0.950)〕,while TSH was the risk factor〔OR=2.234,95%CI(1.061,4.706),P<0.05〕.Conclusion FT3 is significantly decreased and TSH is significant elevated in type 2 diabetes mellitus patients complicated with coronary heart disease,both FT3 and TSH were influencing factors of coronary heart disease in patients with type 2 diabetes mellitus.