甲状腺功能亢进性心脏病相关危险因素分析

Analysis of risk factors on hyperthyroidism heart disease

目的分析甲状腺功能亢进性心脏病(简称甲亢心)的临床危险因素,为临床早期诊疗提供依据。方法根据纳排标准收集病例并分为3组,其中对照组为健康体检者,共121例;甲亢组为确诊甲状腺功能亢进症患者,共150例;甲亢心组为确诊甲状腺功能亢进性心脏病患者,共157例。分析3组之间相关研究指标的差异,并进行Logistic回归分析。结果甲亢心组年龄大、病程长,房颤及左心增大是其最常见的心脏异常表现。甲亢心组游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)升高,促甲状腺激素(TSH)下降。甲亢心组中性粒细胞淋巴细胞比(NLR)升高,白细胞(WBC)、中性粒细胞(NEUT)、淋巴细胞(LYM)减低。甲亢心组甘油三酯(TG)、总胆固醇(TC)明显下降。3组间肌酸激酶(CK)无统计学差异,甲亢心组乳酸脱氢酶(LDH)、α-羟丁酸脱氢酶(α-HBDH)升高。结论年龄大、病程长、FT4升高、NLR升高、血脂减低、LDH升高、α-HBDH升高是甲亢心的临床危险因素,早期监测上述指标可对甲亢心的诊断与治疗提供一定的帮助。

Objective To analyze the clinical risk factors of hyperthyroidism heart disease(HHD)and provide the basis for early diagnosis and treatment.Methods 428 cases were collected and divided into three groups:the health group with 121 person,the hyperthyroidism group with 150 patients and HHD group with 157 patients.The differences among the three groups were explored and Logistic regression analysis was conducted.Results Patients in HHD group were older and had a longer process of disease,atrial fibrillation and left heart enlargement were the most common cardiac abnormalities;Compared with the control group,free triiodothyronine(FT3)and free thyroxine(FT4)in HHD group increased while thyroid stimulating hormone(TSH)decreased;Neutrophil to lymphocyte ratio(NLR)in HHD group were higher than that in other two groups,while white blood cell(WBC),neutrophil(NEUT),lymphocyte(LYM)in control group were higher than the others;Triglyceride(TG),cholesterol(TC)decreased significantly in HHD group;There was no statistically significant difference in creatine kinase(CK)among three groups,while lactic dehydrogenase(LDH)andα-hydroxybutyrate dehydrogenase(α-HBDH)increased.Conclusion The patients with elder age,longer course of disease,increased FT4,NLR,LDH,α-HBDH and decreased serum lipid level are clinical risk factors for HHD.And it is helpful for diagnosis and treatment by early monitoring of the above indicators.