甲状腺激素对老年慢性心力衰竭病人颈动脉内膜中层厚度的影响

doi:10.3969/j.issn.1003-9198.2022.08.012

摘要/Abstract

摘要： 目的分析甲状腺激素对老年慢性心力衰竭病人颈动脉内膜中层厚度(IMT)的影响。方法对2017年6月至2021年6月期间我院收治的108例老年慢性心力衰竭病人临床资料进行回顾性分析。依据病人的IMT将病人分为增厚组(IMT≥1.0 mm,n=46)和未增厚组(IMT＜1.0 mm,n=62),比较2组病人的一般资料和临床资料,采用Logistic回归分析老年慢性心力衰竭病人IMT增厚的影响因素。同时依据病人的血清促甲状腺激素(TSH)四分位数水平将其分为低组(TSH＜1.00 mIU/L,n=26)、中组(1.00 mIU/L≤TSH≤2.74 mIU/L,n=55)和高组(TSH＞2.74 mIU/L,n=27),比较不同TSH水平病人的IMT和斑块检出情况。结果与未增厚组病人相比,增厚组病人的年龄较高、病程较长、游离甲状腺素水平较低,TSH、CRP、TC、载脂蛋白A1水平较高,差异均有统计学意义(P＜0.05)。Logistic回归分析结果显示,年龄≥70岁、TSH≥3 mIU/L、CRP≥3.5 mmol/L、TC≥4.5 mmol/L是老年慢性心力衰竭病人IMT增厚的独立危险因素。与TSH高组病人相比,低组和中组病人的IMT降低,差异有统计学意义(P＜0.05);不同TSH水平病人的斑块检出情况差异无统计学意义(P＞0.05)。结论年龄、TSH、CRP、TC水平对老年慢性心力衰竭病人IMT的增厚均可能产生影响。

关键词: 慢性心力衰竭, 老年人, 甲状腺激素, 颈动脉内膜中层厚度

Abstract: Objective To analyze the effect of thyroid hormones on carotid intima-media thickness (IMT) in the elderly patients with chronic heart failure. Methods A retrospective analysis was performed on 108 elderly patients with chronic heart failure admitted to our hospital from June 2017 to June 2021. According to the level of IMT, the patients were divided into the thickening group (IMT≥1.0 mm, n=46) and the non-thickening group (IMT<1.0 mm, n=62). The general data and clinical data of the two groups were compared, and the influencing factors of IMT in the elderly patients with chronic heart failure were analyzed by Logistic regression. At the same time, the patients were divided into low group (TSH<1.00 mIU/L, n=26), medium group (1.00 mIU/L≤TSH≤2.74 mIU/L, n=55) and high group (TSH > 2.74 mIU/L, n=27) according to the quartile level of TSH. The level of IMT and carotid artery plaque number of the patients with different TSH levels were compared. Results Compared with the non-thickening group, the patients in the thickening group were older, and had longer course of disease, lower level of free thyroxine acid, and higher levels of TSH, C-reactive protein (CRP), total cholesterol (TC) and apolipoprotein A1, with statistical significance (P<0.05). Logistic regression analysis showed that aged ≥70 years old, TSH≥3 mIU/L, CRP≥3.5 mmol/L and TC≥4.5 mmol/L were the independent risk factors of IMT thickening in the elderly patients with chronic heart failure. Compared with the high group, the level of IMT in the low group and the middle group were significantly decreased (P<0.05). There was no significant difference in carotid artery plaque number among the patients with different TSH levels (P>0.05). Conclusions The development of IMT might be correlated with age, TSH, CRP and TC in the elderly patients with chronic heart failure.

Key words: chronic heart failure, aged, thyroid hormones, carotid artery intima-media thickness

中图分类号:

R541.6

汪波, 马云飞, 王可. 甲状腺激素对老年慢性心力衰竭病人颈动脉内膜中层厚度的影响[J]. 实用老年医学, 2022, 36(8): 801-804.

WANG Bo, MA Yun-fei, WANG Ke. Effect of thyroid hormones on carotid artery intima-media thickness in elderly patients with chronic heart failure[J]. Practical Geriatrics, 2022, 36(8): 801-804.

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