血清FT_(3)、TSH水平与颈动脉粥样硬化斑块稳定性的关系研究

Relationship between serum FT3 and TSH levels and carotid atherosclerotic plaque stability

目的:研究血清游离三碘甲状腺原氨酸(FT_(3))、促甲状腺激素(TSH)水平与颈动脉粥样硬化斑块稳定性的关系。方法:选取2020年10月至2021年10月本院收治的156例颈动脉粥样硬化斑块患者作为研究对象,根据颈动脉彩超声检测斑块稳定性结果将其分为不稳定斑块组(89例)和稳定斑块组(67例)。比较两组血清FT_(3)、TSH水平。采用多因素Logistic回归性分析法分析颈动脉粥样硬化斑块稳定性的影响因素,受试者工作特征(ROC)曲线分析血清FT_(3)、TSH水平对颈动脉粥样硬化斑块稳定性的预测价值。结果:不稳定斑块组FT_(3)水平低于稳定斑块组,TSH水平高于稳定斑块组(均P<0.05)。不稳定斑块组年龄>65岁、高血压占比和LDL-C、TG、hs-CRP水平均高于稳定斑块组(P<0.05)。FT_(3)水平降低、TSH水平升高为颈动脉粥样硬化斑块不稳定的独立危险因素(P<0.05);ROC分析结果显示,FT_(3)联合TSH预测颈动脉粥样硬化斑块不稳定的ROC曲线下面积(AUC)为0.875,高于单独预测(P<0.05),两者联合诊断的灵敏度和特异度分别为84.27%、83.58%,与单独诊断比较无明显差异(P>0.05)。结论:颈动脉粥样硬化斑块患者血清FT_(3)、TSH水平均与斑块稳定性密切相关,两者联合可提高斑块稳定性的预测效能。

Objective:To study the relationship between serum free triiodothyronine(FT_(3))and thyroid stimulating hormone(TSH)levels and the stability of carotid atherosclerotic plaques.Methods:156 patients with carotid atherosclerotic plaques admitted to our hospital from October 2020 to October 2021 were selected as study subjects,and they were divided into unstable plaque group(89 cases)and stable plaque group(67 cases)according to the results of carotid ultrasound detection of plaque stability.Serum FT_(3) and TSH levels were compared between the two groups.The factors influencing the stability of carotid atherosclerotic plaques were analyzed by logistic multi-factor regression analysis,and the predictive value of serum FT_(3) and TSH levels for the stability of carotid atherosclerotic plaques were analyzed by receiver operating characteristic(ROC)curves.Results:The FT_(3) levels in the unstable plaque group were lower than those in the stable plaque group,and the TSH levels were higher than those in the stable plaque group(all P<0.05).The number of patients aged>65 years,incidence of hypertension and LDL-C,TG and hs-CRP levels were higher in the unstable plaque group than in the stable plaque group(P<0.05).Reduced FT_(3) levels and increased TSH levels were independent risk factors for carotid athero-sclerotic plaque instability(P<0.05);the results of ROC analysis showed that the area under the ROC curve(AUC)of FT_(3) combined with TSH to predict carotid plaque instability was 0.875,which was higher than that of single-factor predictions(P<0.05),and the sensitivity and specificity of their combined diagnosis were 84.27%and 83.58%,respectively,which were not significantly different from that of single-factor diagnosis(P>0.05).Conclusion:Both serum FT_(3) and TSH levels are closely related to plaque stability in patients with carotid athero-sclerotic plaques,and the combination of the two can improve the predictive efficacy for plaque stability.