1级亚临床甲状腺功能减退症促甲状腺激素水平与冠状动脉狭窄程度的相关性研究

The relevance study of the level of serum thyroid stimulating hormone of grade 1 subclinical hypothyroidism and extent of coronary artery lesions

目的:探讨冠心病患者外周血促甲状腺激素与冠状动脉(冠状动脉)病变程度的相关性。方法:采用前瞻性研究,连续选取2017年10月至2019年10月首次于北京安贞医院心内科住院治疗的冠心病患者103例,入院后根据甲状腺功能(甲功)检查结果将其分为甲功正常合并冠心病组和1级亚甲状腺功能减退症合并冠心病组。完善冠状动脉造影,记录血管病变数量及病变程度,并行Gensini评分。采用多元线性回归分析研究血清促甲状腺激素与冠心病患者冠状动脉狭窄程度之间的相关性。结果:1级亚临床甲状腺功能减退症合并冠心病患者Gensini评分和病变数量均高于甲功正常合并冠心病患者(P≤0.001)。相关性分析显示,1级亚临床甲状腺功能减退症范围内促甲状腺素水平与冠状动脉Gensini评分和冠状动脉病变数量呈显著正相关(P<0.05)。结论:外周血促甲状腺激素水平与冠状动脉狭窄病变程度密切相关,1级亚甲状腺功能减退症是冠心病的危险因素。

Objective:To explore the correlation between the level of serum thyroid stimulating hormone of grade 1 subclinical hypothyroidism and extent of coronary artery lesions.Methods:A total of 103 patients who were hospitalized in the department of cardiology,Beijing Anzhen Hospital from October 2017 to October 2019 and diagnosed as coronary artery disease were enrolled.According to the result of the thyroid function tests,patients were divided into the euthyroid coronary artery disease group and the grade 1 subclinical hypothyroid coronary artery disease group.According to the result of coronary angiography,the number and the extent of vascular lesions were recorded and the gensini scores were performed.We used multiple linear regression analysis to investigate the correlation between serum thyroid stimulating hormone and the number and extent of vascular lesions in patients with coronary artery disease.Results:The gensini scores and the number of lesions in patients with grade 1 subclinical hypothyroidism and coronary artery disease were higher than those with euthyroid coronary artery disease(P≤0.001).The correlation analysis showed that the level of thyroid stimulating hormone in the range of grade 1 subclinical hypothyroidism was significantly positively correlated with the coronary gensini scores and the number of coronary lesions(P<0.05).Conclusions:Serum thyroid stimulating hormone levels are closely related to the extent of coronary artery lesions.Grade 1 hypothyroidism is a risk factor for coronary artery disease.