甲状腺功能正常的2型糖尿病患者甲状腺激素水平与冠心病严重程度和心脏功能的关系

发布时间：2018-06-16 17:19

  本文选题：甲状腺激素 + 型糖尿病　； 参考：《中国动脉硬化杂志》2017年09期

【摘要】：目的探讨甲状腺功能正常的2型糖尿病(T2DM)患者甲状腺激素水平对冠状动脉病变严重程度和心脏功能的影响。方法 415例经冠状动脉造影检查诊断为冠心病的住院患者按是否合并T2DM分为糖尿病组131例和对照组284例。检测生物化学指标、甲状腺激素水平、心脏结构参数、心功能及颈动脉内膜中膜厚度(IMT),并计算Gensini评分;进一步按Gensini评分的三分位数将糖尿病组分为低分组34例(≤15分)、中分组33例(16~42分)及高分组64例(≥43分),比较上述指标。并采用多元线性回归分析甲状腺激素与Gensini评分的相关性。结果糖尿病组Gensini评分、心率、FBG、Hb A1c、TG、BUN、MPV、IMT、LVDd及LVPWT较对照组显著升高,而FT3、LVEF显著降低(P均0.05)。糖尿病各亚组间FT3随着Gensini评分的增加有下降的趋势,高分组显著低于低分组(P0.05)。多元线性回归分析显示,Hb A1c、Cr、ALT、TG、LDLC及促甲状腺激素是Gensini评分的独立危险因素。TSH与E/A呈负相关(r=-0.128,P=0.013),FT4与IMT呈正相关(r=0.113,P0.05)。结论促甲状腺激素可作为冠状动脉病变的一个独立危险因素。FT3水平虽不与冠心病的严重程度独立相关,但对于低FT3水平的T2DM患者,仍应重视其心脏功能的评估。
[Abstract]:Objective to investigate the effect of thyroid hormone level on the severity of coronary artery disease and cardiac function in type 2 diabetes mellitus (T2DM) with normal thyroid function. Methods 415 inpatients with coronary artery disease diagnosed by coronary angiography were divided into diabetes group (131 cases) and control group (284 cases) according to whether they were complicated with T2DM. Biochemical parameters, thyroid hormone level, cardiac structural parameters, cardiac function and carotid intima-media thickness were measured and Gensini score was calculated. According to the three digits of Gensini score, 34 cases of diabetes were divided into low group (鈮，

本文编号：2027500