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汪红平,任颖,魏盟,等.慢性心力衰竭患者甲状腺激素水平与远期生存率的相关分析[J].同济大学学报（医学版）,2013,34(1):48-54. [点击复制]
WANG Hong-ping,REN Ying,WEI Meng,et al.Correlation between thyroid hormone levels and long-term survival in patients with chronic heart failure[J].同济大学学报（医学版）,2013,34(1):48-54. [点击复制]

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慢性心力衰竭患者甲状腺激素水平与远期生存率的相关分析
汪红平^1,2,任颖^1,2,魏盟³,邵琦^1,2
0 字体:加大+\|默认\|缩小-
(1.上海交通大学附属第六人民医院特需医疗科，上海200233; 2.上海市糖尿病临床医学中心,上海200233;3.上海交通大学附属第六人民医院心内科，上海200233)

摘要:

目的探讨慢性心力衰竭（chronic heart failure,CHF）患者甲状腺激素水平与远期生存率的相关性。方法入选355例CHF患者,入院后测定甲状腺激素水平、血糖血脂、行心脏超声检查并进行远期随访,比较各组指标并分析远期生存率。结果将人群FT₃值分为4分位数,位于下1/4位点者的住院时间、白细胞、中性粒细胞百分比、尿酸、肌酐、促甲状腺激素（thyroid stimulating hormone,TSH）明显高于上1/4位点者（P<0.05）,而红细胞、总蛋白、白蛋白、三酰甘油（triglyceride,TG）、左室射血分数（left ventricular ejection fraction,LVEF）、游离甲状腺素（FT₄）、血清钠、血清钙明显低于上1/4位点者（P<0.05）。Cox模型分析显示,在校正多因素后,游离三碘甲状腺原氨酸（FT₃）是影响CHF患者全因死亡率和心源性死亡率的独立危险因子,FT₃每下降1 pmoL/L,死亡风险增加49.8%,其次是LVEF和年龄。结论 FT₃是影响CHF患者全因死亡率和心源性死亡率的独立危险因子,低FT₃状态与慢性心力衰竭患者远期生存率相关。

关键词: 非甲状腺性病态综合征慢性心力衰竭病死率

DOI：10.3969/j.issn1008-0392.2013.01.011

基金项目:

Correlation between thyroid hormone levels and long-term survival in patients with chronic heart failure

WANG Hong-ping^1,2,REN Ying^1,2,WEI Meng³,SHAO Qi^1,2

(1.Dept.of Special Medical Services,Sixth People’s Hospital,Shanghai Jiaotong University,Shanghai 200233,China; 2.Shanghai Clinical Center for Diabetes,Shanghai 200233,China;;3.Dept.of Cardiology,Sixth People’s Hospital,Shanghai Jiaotong University,Shanghai 200233,China)

Abstract:

Objective To evaluate the correlation between thyroid hormone levels and long-time survival in patients with chronic heart failure （CHF）. Methods A total of 355 CHF patients were included in this study. Thyroid hormone profile, serum lipid and glucose were measured, echocardiography was examined. The correlation of thyroid hormone levels with long-time survival was analyzed. Results Quartiles of serum free triiodothyronine （FT₃） levels were computed. Compared with those in the highest quartile of FTFT₃, length of hospital stay, WBC, neutrophils percentage, uric acid, serum creatinine and TSH were higher in the lowest quartile group （P＜0.05）, but RBC, total protein, albumin, triglyceride （TG）, left ventricular ejection fraction（ LVEF）, FT₄, serum sodium and serum calcium were lower （P＜0.05）. Cox regression displayed that FT₃ was an independent factor associate with all-cause mortality and cardiac mortality, followed by LVEF and age. An decrease of 1 pmol/L in FT₃ was associated with an increase in mortality risk of 49.8 %. Conclusion FT₃ is an independent risk factor for all-cause and cardiac mortality and low FT₃ state is related to long-time survival in chronic heart failure patients.

Key words: nonthyroidal illness syndrome chronic heart failure mortality