冠心病合并亚临床甲状腺功能减退症患者的临床特点及预后

发布时间：2018-05-19 13:53

  本文选题：冠心病 + 亚临床甲状腺功能减退症　； 参考：《山西医科大学》2017年硕士论文

【摘要】：目的:研究冠心病合并亚临床甲状腺功能减退症(SCH)患者的临床资料、冠脉造影特点及预后。方法:选取2015年10月~2016年4月在山大一院心血管内科行冠状动脉造影(CAG)确定为冠心病(CHD)的患者369例,根据冠心病是否合并有亚临床甲状腺功能减退症将其分为两组:冠心病亚甲减组(CHD+SCH组,101例),冠心病组(CHD组,268例),分别记录这369例患者的临床基本资料、冠脉造影特点(冠脉病变支数、部位、狭窄程度、弥漫性、Gensini评分)以及随访出院6个月后MACE事件的发生情况(再发心绞痛、重复PCI、心力衰竭、卒中、心因性死亡)。应用统计学方法对这些数据进行整理分析,观察比较两组患者在临床、冠脉造影的特点以及预后方面是否有统计学差异。结果:(1)在冠心病亚甲减组中,女性患者比例显著高于CHD组(P0.001),有吸烟史的比例明显低于CHD组(P0.001),且合并高血压(72.3%)、颈动脉硬化斑块者(54.5%)比例明显高于CHD组(60.1%、35.4%,P均0.05);(2)与CHD组比较,冠心病亚甲减组总胆固醇[TC,(4.71±1.46)比(4.24±1.09)mmol/L]、低密度脂蛋白胆固醇[LDL-C,(2.70±0.87)比(2.43±0.92)mmol/L]、载脂蛋白B[APOB,(0.87±0.25)比(0.80±0.23)mmol/L]、血小板体积分布宽度[PDW,(17.06±0.59)比(16.85±0.71)%]、纤维蛋白原定量[FIB,(3.93±0.91)比(3.61±0.89)g/L]水平明显升高(P均0.05);(3)冠脉造影结果显示:两组患者冠状动脉病变特点无显著差异(P0.05)。(4)两组患者6个月后主要心血管不良事件(MACE事件)发生率的差异无统计学意义(P0.05)。结论:冠心病合并亚临床甲状腺功能减退症(SCH)患者颈动脉斑块发生率高,且多合并有高血压、血脂代谢紊乱以及凝血异常等多种心血管危险因素,应积极干预以延缓动脉粥样硬化(AS)性疾病的发生。
[Abstract]:Objective: to study the clinical data, coronary angiography and prognosis of patients with coronary heart disease complicated with subclinical hypothyroidism. Methods: from October 2015 to April 2016, 369 patients who underwent coronary angiography (CAG) in the Department of Cardiovascular Medicine of the first Hospital of Shanshan University were selected and identified as coronary heart disease (CHD). According to whether coronary heart disease is complicated with subclinical hypothyroidism, it is divided into two groups: subhypothyroidism coronary heart disease (CHD) subhypothyroidism group (n = 101) and coronary heart disease (CHD) group (n = 268). The characteristics of coronary angiography (number of coronary lesion branches, site, degree of stenosis, Gensini score of diffuse stenosis) and MACE events (recurrent angina pectoris, repeated PCI, heart failure, stroke, cardiogenic death) and 6 months after discharge from hospital. Statistical methods were used to analyze these data and to observe whether there were statistical differences in clinical features and prognosis between the two groups. Results the percentage of female patients with subthyroidism of coronary heart disease was significantly higher than that of CHD group (P 0.001), the proportion of patients with smoking history was significantly lower than that of CHD group (P 0.001), and the proportion of patients with hypertension 72.3%, carotid atherosclerotic plaques 54.5%) was significantly higher than that of CHD group (60.1% P 0.05) and CHD group. 鍐犲績鐥呬簹鐢插噺缁勬，

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