甲状腺功能与冠心病及病变支数的相关性研究

The correlation of thyroid function with coronary heart disease and lesion numbers

目的探讨促甲状腺激素(TSH)在正常范围内的甲状腺功能与冠心病及累及的病变支数的相关性。方法回顾性研究北京市门头沟区医院心血管内科2018年1月至12月住院患者共258例。根据造影结果,按病变程度将其分为冠心病组172例及非冠心病组86例,按照累及病变血管支数分为0支组(86例)、1支组(60例)、2支组(56例)、3支组(56例)。空腹采血,检测甲状腺功能相关指标总三碘甲状腺原氨酸(TT_(3))、游离T_(3)(FT_(3))、游离甲状腺素(FT_(4))、TSH,比较各项指标在各组间的差异及相关性分析。结果冠心病组TSH水平高于非冠心病组,差异有统计学意义(P<0.05)。单因素回归分析结果显示TSH(OR=1.385,95%CI:1.068~1.797,P<0.05)及多因素回归分析结果显示TSH(OR=1.362,95%CI:1.049~1.768,P<0.05)是冠心病的独立危险因素。在病变支数0支组、1支组、2支组、3支组中,各组间TSH比较,差异有统计学意义(P<0.05)。单因素线性回归分析中,TSH(β=0.303,95%CI:0.172~0.433,P<0.001)与冠脉病变数之间存在线性回归关系。多元线性回归分析得出回归方程为:冠脉病变数=0.669+0.316×TSH。结论在正常范围内的TSH水平是冠心病的独立危险因素,且与冠脉病变支数存在线性相关性。

Objective To investigate the correlation of thyroid function in normal range of thyroid stimulating hormone(TSH)with coronary heart disease and the number of lesion vessel.Methods A total of 258 inpatients in the Department of Cardiaology,Mentougou District Hospital of Beijing from January to Decmber in 2018 were retrospectively studied.According to the results of angiography,they were divided into coronary heart disease group(172 cases)and non-coronary heart disease group(86 cases).According to the number of stenosed coronary vessels,they were divided into 0 vessel group(86 cases),1 vessel group(60 cases),2 vessels group(56 cases)and 3 vessels group(56 cases).Fasting blood was collected to detect thyroid function related indicators total triiodothyronine(TT_(3)),free T_(3)(FT_(3)),free thyroxine(FT_(4))and TSH.and the differences and correlation analysis of each index between groups were compared.Results The level of TSH in coronary heart disease group was higher than that in non-coronary heart disease group,the difference was statistically significant(P<0.05).Univariate regression analysis showed that TSH(OR=1.385,95%CI:1.068-1.797,P<0.05),and multivariate regression analysis showed that TSH(OR=1.362,95%CI:1.049-1.768,P<0.05)was an independent risk factor for coronary heart disease.There were statistically significant differences in TSH among groups with 0,1,2 and 3 vessel lesions groups(P<0.05).In univariate linear regression analysis,TSH(β=0.303,95%CI:0.172-0.433,P<0.001)and the number of coronary artery lesions.Multiple linear regression analysis showed that the regression equation was:the number of coronary artery lesions=0.669+0.316×TSH.Conclusion TSH level in the normal range is an independent risk factor for CHD,and has a linear correlation with the number of coronary artery lesions.