| 孟 静,何 婷,李 华,梁 佳,宿宁宁.老年慢性心力衰竭患者甲状腺激素水平与认知功能、心功能及心血管事件的关系研究[J].,2021,(23):4531-4535 |
| 老年慢性心力衰竭患者甲状腺激素水平与认知功能、心功能及心血管事件的关系研究 |
| Study on the Relationship between Thyroid Hormone Levels and Cognitive Function, Heart Function and Cardiovascular Events in Elderly Patients with Chronic Heart Failure |
| 投稿时间：2021-04-07 修订日期：2021-04-30 |
| DOI：10.13241/j.cnki.pmb.2021.23.028 |
| 中文关键词: 慢性心力衰竭 甲状腺激素 认知功能 心功能 心血管事件 |
| 英文关键词: Chronic heart failure Thyroid Hormone Cognitive function Cardiac Function Cardiovascular events |
| 基金项目:新疆维吾尔自治区自然科学基金项目（2015211C162） |
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| 中文摘要: |
| 摘要 目的：探讨老年慢性心力衰竭（CHF）患者甲状腺激素（TH）水平与认知功能、心功能及心血管事件的关系。方法：将我院2018年6月～2020年6月收治的140例老年CHF患者纳入研究，检测患者TH指标[血清三碘甲状腺原氨酸（T3）、游离三碘甲状腺原氨酸（FT3）、甲状腺素（T4）、游离甲状腺素（FT4）、促甲状腺激素（TSH）]水平。按蒙特利尔认知评估量表（MoCA）评分将患者分为认知障碍组（MoCA评分＜26分）、非认知障碍组（MoCA评分≥26分），比较两组各TH指标与MoCA评分。比较不同纽约心脏病协会（NYHA）分级患者的TH指标与心功能指标[左室射血分数（LVEF）、左室舒张末期内径（LVEDD）、左室收缩末期内径（LVESD）]。根据患者住院期间是否发生心血管事件分为心血管事件组和非心血管事件组，比较两组各TH指标。经Pearson线性相关分析TH指标与MoCA评分、心功能指标的相关性。结果：认知障碍组血清T3、FT3水平及MoCA评分较非认知障碍组明显降低（P＜0.05）。Ⅲ级、Ⅳ级组的血清T3、FT3水平及LVEF较Ⅰ级、Ⅱ级组显著降低，其中Ⅳ级组低于Ⅲ级组（P＜0.05）。Ⅲ级、Ⅳ级组的LVEDD、LVESD较Ⅰ级、Ⅱ级组明显升高，且Ⅳ级组高于Ⅲ级组（P＜0.05）。心血管事件组血清T3、FT3水平较非心血管事件组显著降低（P＜0.05）。Pearson线性相关分析显示：血清T3、FT3水平与MoCA评分、LVEF呈正相关（均P＜0.05），与LVEDD、LVESD呈负相关（均P＜0.05）。结论：老年CHF患者血清T3、FT3水平下调与其认知功能、心功能降低及心血管事件的发生密切相关，通过检测其血清T3、FT3水平，有利于进一步了解其病情变化。 |
| 英文摘要: |
| ABSTRACT Objective: To explore the relationship between thyroid hormone (TH) and cognitive function, heart function and cardiovascular events in elderly patients with chronic heart failure (CHF). Methods: A total of 140 elderly patients with CHF who were admitted to our hospital from June 2018 to June 2020 were included in the study. The TH indicators [serum triiodothyronine (T3), free triiodothyronine (FT3), thyroxine (T4), free thyroxine (FT4) and thyroid-stimulating hormone (TSH)] were measured in patients. The patients were divided into cognitive impairment group(MoCA scores＜26) and non-cognitive impairment group(MoCA scores≥26) according to by the Montreal cognitive assessment (MoCA) score, the TH indicators and MoCA scores of the two groups were compared. The TH indicators and cardiac function indicators [left ventricular ejection fraction (LVEF), left ventricular end diastolic diameter (LVEDD), left ventricular end systolic diameter (LVESD)] in different New York Heart Association (NYHA) grading standard group were compared. the patients were divided into cardiovascular event group and non cardiovascular event group according to whether cardiovascular events occurred during hospitalization, and the TH indicators of the two groups were compared. Pearson linear correlation analysis was used to analyze the correlation between each TH indicator and MoCA score and cardiac function indicators. Results: The levels of serum T3, FT3 and MoCA scores in the cognitive impairment group were significantly lower than those in the non-cognitive impairment group (P<0.05). Serum T3, FT3 levels and LVEF in the grade Ⅲ and Ⅳ groups were significantly lower than those in the grade Ⅰ and grade Ⅱ groups, and the grade Ⅳ group was lower than the grade Ⅲ group (P<0.05). LVEDD and LVESD in grade III and IV groups were significantly larger than those in grade I and II groups, and the grade IV group was greater than grade III group (P<0.05). Serum T3 and FT3 levels in the cardiovascular event group were significantly lower than those in the non cardiovascular event group (P<0.05). Pearson linear correlation analysis showed that serum T3 and FT3 levels were positively correlated with MoCA score and LVEF (all P＜0.05), and negatively correlated with LVEDD and LVESD (all P<0.05). Conclusion: The down-regulation of serum T3 and FT3 levels in elderly patients with CHF is closely related to the occurrence of cognitive function, cardiac function, and cardiovascular events. The detection of serum T3 and FT3 levels will help to further understand the changes in their condition. |
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