老年亚临床甲状腺功能减退症与急性冠脉综合征的相关性分析

doi:10.3969/j.issn.1003-9198.2022.02.014

实用老年医学 ›› 2022, Vol. 36 ›› Issue (2): 164-167.doi: 10.3969/j.issn.1003-9198.2022.02.014

老年亚临床甲状腺功能减退症与急性冠脉综合征的相关性分析

孙宇, 王艳, 徐书杭, 刘超

223800 江苏省宿迁市,徐州医科大学附属宿迁医院内分泌科(孙宇);老年医学科(王艳);
210028 江苏省南京市,南京中医药大学附属中西医结合医院(江苏省中西医结合医院)内分泌科(徐书杭,刘超)

收稿日期:2021-03-31 出版日期:2022-02-20 发布日期:2022-02-28
通讯作者: 刘超,liuchao@nfmcn.com
基金资助:
2020年江苏省重点研发计划(BE2020726);2020年宿迁市重点研发计划项目(S202017)

Correlation between subclinical hypothyroidism and acute coronary syndromes in the elderly

SUN Yu, WANG Yan, XU Shu-hang, LIU Chao

SUN Yu. Department of Endocrinology and Metabolism; WANG Yan. Department of Geriatrics, Suqian Hospital Affiliated to Xuzhou Medical University, Suqian 223800, China;
XU Shu-hang, LIU Chao. Department of Endocrinology and Metabolism, Affiliated Hospital of Integration of Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing 210028, China

Received:2021-03-31 Online:2022-02-20 Published:2022-02-28

摘要/Abstract

摘要： 目的探讨老年亚临床甲状腺功能减退症(SCH)与急性冠脉综合征(ACS)的相关性。方法纳入 2017年1月至 2021年1月因胸痛在徐州医科大学附属宿迁医院心内科住院并行冠状动脉造影明确诊断为CHD的老年病人247例,根据病情分为ACS组和稳定型CHD(SCHD)组。收集病人一般临床资料、血清促甲状腺激素(TSH)、游离甲状腺素(FT4)、游离三碘甲状腺原氨酸(FT3)及其他生化指标水平,应用我国老年人TSH特异性参考范围值(＞8.56 mIU/L)诊断SCH,采用多因素Logistic回归模型分析ACS的危险因素。结果 ACS组的男性、高血压、吸烟史比例和SCH发生率高于SCHD组(P＜0.05)。 ACS组TSH水平高于SCHD组(P＜0.05)。多因素Logistic回归分析显示,SCH是ACS的独立相关危险因素。结论 SCH是ACS的独立相关危险因素,相较于SCHD病人,ACS病人的TSH水平更高,后者可能促进ACS的进展。

关键词: 老年人, 亚临床甲状腺功能减退症, 急性冠脉综合征, 相关性分析

Abstract: Objective To investigate the correlation between subclinical hypothyroidism(SCH) and acute coronary syndrome(ACS) in the elderly. Methods Two hundreds and forty-seven elderly patients with chest pain who were admitted to Department of Cardiology, Suqian Hospital Affiliated to Xuzhou Medical University and diagnosed with coronary heart disease (CHD) by coronary angiography(CAG) were included from January 2017 to January 2021. They were divided into ACS group and stable coronary heart disease (SCHD) group.General clinical data, the levels of serum thyroid stimulating hormone(TSH), free thyroxine(FT4), free triiodothyronine(FT3) and other biochemical parameters were collected. An age-specific serum TSH reference range was used for the diagnosis of SCH in the elderly. Multiariable Logistic regression model was applied to analyze the correlation between SCH and the severity of CHD. Results The proportion of male, hypertension, history of smoking and the incidence rate of SCH in ACS group were higher than those in SCHD group(P<0.05).The level of TSH in ACS group was higher than that in SCHD group(P<0.05).Multivariate Logistic regression analysis showed that SCH was positively correlated with ACS. Conclusions SCH is an independent risk factor for ACS in elderly patients. The level of TSH in patients with ACS is higher than that in patients with SCHD, and TSH may promote the progression of ACS.

Key words: aged, subclinical hypothyroidism, acute coronary syndromes, correlation analysis

中图分类号:

孙宇, 王艳, 徐书杭, 刘超. 老年亚临床甲状腺功能减退症与急性冠脉综合征的相关性分析[J]. 实用老年医学, 2022, 36(2): 164-167.

SUN Yu, WANG Yan, XU Shu-hang, LIU Chao. Correlation between subclinical hypothyroidism and acute coronary syndromes in the elderly[J]. Practical Geriatrics, 2022, 36(2): 164-167.

参考文献

[1] BIONDI B, CAPPOLA A R, COOPER D S. Subclinical hypothyroidism: a review[J]. JAMA,2019,322(2):153-160.
[2] CAPPOLA A R, DESAI A S, MEDICI M, et al. Thyroid and cardiovascular disease research agenda for enhancing knowledge, prevention, and treatment[J]. Circulation,2019, 136(22):2100-2116.
[3] HENNESSEY J V, ESPAILLAT R. Subclinical hypothyroidism: a historical view and shifting prevalence[J]. Int J Clin Pract,2015,69(7):771-782.
[4] HOLLOWELL J G, STAEHLING N W, FLANDERS W D, et al. Serum TSH, T(4), and thyroid antibodies in the United States population(1988 to 1994): National Health and Nutrition Examination Survey(NHANES III)[J]. J Clin Endocrinol Metab,2002,87(2):489-499.
[5] ZHAI X, ZHANG L, CHEN L, et al. An age-specific serum thyrotropin reference range for the diagnosis of thyroid diseases in older adults: a cross-sectional survey in China[J]. Thyroid,2018,28(12):1571-1579.
[6] 中华医学会心血管病学分会,中华心血管病杂志编辑委员会.急性ST段抬高型心肌梗死诊断和治疗指南(2019)[J]. 中华心血管病杂志,2019,47(10):766-783.
[7] 中华医学会心血管病学分会,中华心血管病杂志编辑委员会. 非ST段抬高型急性冠状动脉综合征诊断和治疗指南(2016)[J]. 中华心血管病杂志,2017,45(5):359-376.
[8] 中华医学会内分泌学分会. 成人甲状腺功能减退症诊治指南[J]. 中华内分泌代谢杂志,2017,33(2):167-180.
[9] MANOLIS A A, MANOLIS T A, MELITA H, et al. Subclinical thyroid dysfunction and cardiovascular consequences: An alarming wake-up call?[J]. Trends Cardiovasc Med,2020,30(2):57-69.
[10] NING Y, CHENG Y J, LIU L J, et al. What is the association of hypothyroidism with risks of cardiovascular events and mortality? A meta-analysis of 55 cohort studies involving 1,898,314 participants[J]. BMC Med,2017,15(1):21-27.
[11] YANG C,LU M,CHEN W, et al. Thyrotropin aggravates atherosclerosis by promoting macrophage inflammation in plaques[J]. J Exp Med,2019,216(5):1182-1198.
[12] INOUE K, RITZ B, BRENT G A, et al. Association of subclinical hypothyroidism and cardiovascular disease with mortality[J]. JAMA Network Open,2020,3(2):e1920745.
[13] VADIVELOO T, DONNAN P T, MURPHY M J, et al. Age- and gender-specific TSH reference intervals in people with no obvious thyroid disease in Tayside, Scotland: the Thyroid Epidemiology, Audit, and Research Study(TEARS)[J]. J Clin Endocrinol Metab,2013,98(3):1147-1153.
[14] HAK A E, POLS H A, VISSER T J, et al. Subclinical hypothyroidism is an independent risk factor for atherosclerosis and myocardial infarction in elderly women: the Rotterdam Study[J]. Ann Intern Med,2000,132(4):270-276.
[15] LEGRYS V A, FUNK M J, LORENZ C E, et al. Subclinical hypothyroidism and risk for incident myocardial infarction among postmenopausal women[J].J Clin Endocrinol Metab,2013,98(6):2308-2317.
[16] GOICHOT B, RAVEROT V, KLEIN M, et al. Management of thyroid dysfunctions in the elderly. French Endocrine Society consensus statement 2019. Long version[J]. Ann Endocrinol: Paris, 2020, 81(2/3): 89-100.
[17] TAYLOR P, BIANCO A C. Urgent need for further research in subclinical hypothyroidism[J]. Nat Rev Endocrinol,2019,15(9):503-504.

老年亚临床甲状腺功能减退症与急性冠脉综合征的相关性分析

Correlation between subclinical hypothyroidism and acute coronary syndromes in the elderly

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