老年慢性心力衰竭与低T3综合征的相关性研究

Study on the relationship between chronic heart failure and low T3 syndrome in the elderly

目的研究低T3综合征与老年慢性心力衰竭相关性。方法选取2013年1月至2018年1月解放军火箭军特色医学中心收治的126例老年慢性心力衰竭患者作为心衰组,同期病房无心衰患者126例作为对照组,比较两组血清三碘甲状腺原氨酸(triiodothyronine,T3),游离三碘甲状腺原氨酸(free triiodothyronine,FT3)、甲状腺素(thyroxine,T4)、游离甲状腺素(free thyroxine,FT4)、促甲状腺激素(thyroid stimulating hormone,TSH)、N末端B型钠尿肽前体(N-terminal proB-type natriuretic peptide,NT-proBNP)水平,以及左室射血分数(left ventricular ejection fraction,LVEF)。组间比较采用t检验或单因素方差分析,关联性采用spearman等级相关分析。结果心衰组T3、FT3及LVEF均明显低于对照组,NTproBNP明显高于对照组(P<0.01)。Spearman等级相关性分析显示,LVEF与T3及FT3呈正相关(r=0.632,0.586,P<0.01),NT-proBNP与T3及FT3呈负相关(r=-0.715,-0.656,P<0.01)。结论老年慢性心力衰竭多伴有甲状腺代谢异常,表现为T3、FT3降低,T3、FT3水平与老年慢性心力衰竭的严重程度相关。

Objective To study the relationship between low T3 syndrome and chronic heart failure in the elderly.Methods One hundred and twenty-six elderly patients with chronic heart failure aged 75-95 year old who were admitted to Hospital from January 2013 to January 2018 were selected as the heart failure group,and 126 patients without heart failure in the same time ward were selected as the control group.The serum levels of triiodothyronine(T3),free triiodothyronine(FT3),thyroxine(T4),free thyroxine(FT4)and thyroid stimulating hormone(TSH),NTproBNP,left ventricular ejection fraction(LVEF)were compared between the two groups.T-test or one-way ANOVA was used to compare the difference between groups,and Spearman rank correlation analysis was used for correlation analysis.Results T3,FT3 and LVEF in heart failure group were significantly lower than those in control group,and NTproBNP was significantly higher than that in control group(P<0.01).The results of Spearman grade correlation analysis showed that there was a positive correlation(r=0.632,0.586,P<0.01)between LVEF and T3 and FT3,and there was a negative correlation(r=-0.715,-0.656,P<0.01)between NTproBNP and T3 and FT3.Conclusions The elderly patients with chronic heart failure are often accompanied by thyroid metabolism abnormality,which is manifested by the decrease of T3 and FT3.The level of T3 and FT3 is related to the severity of elderly patients with chronic heart failure.