慢性射血分数降低的缺血性心肌病患者心功能和甲状腺功能的相关性分析

Correlation between cardiac function and thyroid function in ICM patients with chronic decreased ejection fraction

目的探讨慢性射血分数降低的缺血性心肌病(ICM)患者心功能和甲状腺功能的相关性。方法选取2020年5月至2022年5月于河南省直第三人民医院收治的ICM患者110例为研究对象,根据左室射血分数(LVEF)将患者分为对照组(LVEF≥40%,n=49)和研究组(LVEF<40%,n=61)。比较两组纽约心脏病学会(NYHA)分级、左室舒张末期内径(LVEDD)、左心房内径(LAD)、血清游离甲状腺素(FT4)、游离三碘甲状腺原氨酸(FT3)及促甲状腺激素(TSH)水平,比较不同NYHA心功能分级慢性射血分数降低的ICM患者的甲状腺功能,分析慢性射血分数降低的ICM患者心功能和甲状腺功能的相关性。结果两组患者NYHA心功能分级比较,无统计学差异(P>0.05);研究组LVEDD、LAD水平均高于对照组(P<0.05);两组FT4水平比较,无统计学差异(P>0.05)。研究组FT3水平低于对照组、TSH水平高于对照组(P<0.05);不同NYHA心功能分级慢性射血分数降低的ICM患者FT4水平比较,均无显著差异(P>0.05);Ⅲ、Ⅳ级组FT3水平低于Ⅰ级组、TSH水平均高于Ⅰ级组,Ⅳ级组FT3水平低于Ⅱ级组、TSH水平均高于Ⅱ级组(P<0.05)。NYHA心功能分级与TSH呈正相关(P<0.05);LVEDD与FT4、FT3均呈负相关,与TSH呈正相关(P<0.05);LAD与FT4、FT3均呈负相关,与TSH呈正相关(P<0.05)。结论慢性射血分数降低的ICM患者血清FT3水平较低,与LVEDD及LAD呈负相关;慢性射血分数降低的ICM患者血清TSH水平较高,与NYHA心功能分级、LVEDD及LAD呈正相关。

Objective To investigate the correlation between cardiac function and thyroid function in patients with ischemic cardiomyopathy(ICM)with chronic decreased ejection fraction.Methods 110 patients with ICM admitted to the hospital from May 2020 to May 2022 were selected as the study objects.The patients were divided into the control group(LVEF≥40%,n=49)and the study group(LVEF<40%,n=61)according to whether the left ventricular ejection fraction(LVEF)was less than 40%.The NYHA classification,left ventricular end diastolic diameter(LVEDD),left atrial diameter(LAD),serum free thyroxine(FT4),free triiodothyronine(FT3)and thyroid stimulating hormone(TSH)levels were compared between the two groups.To compare the thyroid function indexes of ICM patients with chronic ejection fraction(CEF)reduction in different NYHA cardiac function grades.The correlation between cardiac and thyroid function was analyzed in ICM patients with regular decreased ejection fraction.Results There was no significant difference in NYHA cardiac function between the two groups(P>0.05).LVEDD and LAD levels in the study group were higher than in the control group(P<0.05).There was no significant difference in the level of FT4 between the two groups(P>0.05).The level of FT3 in the study group was lower than that in the control group,and the level of TSH was higher than that in the control group(P<0.05).There was no significant difference in the level of FT4 among ICM patients with chronic ejection fraction reduction in different NYHA cardiac function grades(P>0.05).The FT3 levels in theⅢandⅣgrade groups were lower than those in the I grade group,and the TSH levels were higher than those in theⅠgrade group.The FT3 level in the gradeⅣgroup is lower than that in the gradeⅡgroup,and the TSH level is higher than that in the gradeⅡgroup(P<0.05).NYHA cardiac function grading was positively correlated with TSH(P<0.05).LVEDD was negatively correlated with FT4 and FT3,and positively correlated with TSH(P<0.05).LAD was negatively correlated with FT4 and FT3,and positively correlated with TSH(P<0.05).Conclusion The level of serum FT3 in patients with chronic ejection fraction decrease ICM is low and negatively correlated with LVEDD and LAD.The serum TSH level was higher in patients with chronic ejection fraction reduction ICM,and was positively correlated with NYHA cardiac function grade,LVEDD and LAD.