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目的探讨不稳定型心绞痛患者甲状腺激素水平与冠状动脉病变的关系。方法测定159例不稳定型心绞痛患者血浆游离三碘甲状腺原氨酸(FT3)、血浆游离甲状腺素(FT4)、血浆反三碘甲状腺原氨酸(rT3)和促甲状腺素(TSH)。根据冠脉病变记分分为轻、中、重三组,并与19例冠状动脉造影正常者对照,比较各组甲状腺激素水平,分析甲状腺激素水平与冠脉病变的相关性。结果159例不稳定型心绞痛患者中,重度冠状动脉病变组的血清FT3水平明显低于对照组(P<0.05),中、重度冠状动脉病变组的血清rT3水平均明显高于对照组(P<0.01)。血清FT3水平与冠状动脉病变记分呈负相关,r=-0.3942,P<0.01,血清rT3水平与冠状动脉病变记分呈正相关,r=0.4233,P<0.01。结论不稳定型心绞痛患者血清FT3水平降低,rT3水平升高,FT3和rT3的变化在一定程度上反映冠脉病变的严重性。
Objective To investigate the relationship between thyroid hormone levels and coronary artery disease in patients with unstable angina pectoris. Methods Plasma free triiodothyronine (FT3), plasma free thyroxine (FT4), plasma triglyceride rT3 and thyrotropin (TSH) were measured in 159 patients with unstable angina pectoris. According to the score of coronary artery disease, the patients were divided into mild, moderate and severe groups, and compared with 19 normal coronary angiography. Thyroid hormone levels in each group were compared. The correlation between thyroid hormone level and coronary artery disease was analyzed. Results The serum level of FT3 in 159 patients with unstable angina pectoris was significantly lower than that in the control group (P <0.05), and the levels of serum rT3 in patients with moderate and severe coronary lesions were significantly higher than those in the control group (P < 0.01). The level of serum FT3 was negatively correlated with the score of coronary artery lesion (r = -0.3942, P <0.01). The serum level of rT3 was positively correlated with the score of coronary artery disease (r = 0.4233, P <0.01). Conclusion The serum level of FT3 and the level of rT3 in patients with unstable angina pectoris are elevated. The changes of FT3 and rT3 to a certain extent reflect the severity of coronary lesions.