甲状腺功能亢进性心脏病危险因素分析

目的 探讨甲状腺功能亢进(简称甲亢)性心脏病发生的危险因素,为控制甲亢性心脏病的发生提供科学依据.方法 2010年3月选择自2000年以来在山东省甲状腺疾病防治中心住院的982例甲亢患者,依据是否并发心脏病分为单纯甲亢组和甲亢性心脏病组,就病因、性别、年龄、病程及游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺素(TSH)、促甲状腺激素受体抗体(TRAb)等因素进行比较,并采用Logistic回归方法对甲亢性心脏病发病相关因素进行分析.结果 甲亢患者并发甲亢性心脏病的患病率为7.7%(76/982),甲亢性心脏病组在年龄、病程、FT3和TRAb水平上分别为[(51.4±11.5)岁、(6.3±2.1)年、21.6pmol/L、71.6 U/L],单纯甲亢组为[(37.9±9.8)岁、(2.6±1.3)年、14.9 pmol/L、49.6 U/L],组间比较,差异有统计学意义(u=9.93、15.23,T=44954、48792.5,P均＜0.05).年龄大、FT3,和TRAb水平高、病程长、毒性弥漫性甲状腺肿(相对危险度值分别为1.751、1.470、1.483、1.445、1.234)并发甲亢性心脏病的危险性大.结论 毒性弥漫性甲状腺肿、高龄、病程长、FT3和TRAb水平高是甲亢性心脏病的危险因素,及时预防和控制甲亢性心脏病的危险因素,减少甲亢性心脏病的发生与死亡.

Abstract：

Objective To study the risk factors of hyperthyroid heart diseases(HHD) by analyzing clinical features of patients in order to provide a scientific basis for prevention and treatment of HHD. Methods Nine hundred and eighty two cases were selected as objective from in-patient data of Thyroid Disease Treatment Centre of Shandong Province. The cases were divided into hyperthyroidism group and HHD group. The variables of etiology,sex, age, duration of disease, TSH, FT3, FT4 and TRAb were analyzed by comparative analysis. The risk factors were analyzed by logistic regression. Results The prevalence of hyperthyroidism complicated hyperthyroid heart disease was 7.7%(76/982), age, duration of diseases, FT3, TRAb in the HHD group were [(51.4 ± 11.5), (6.3 ±2.1) years, 21.6 pmol/L, 71.6 U/L], in hyperthyroidism group were [(37.9 ± 9.8), (2.6 ± 1.3) years, 14.9pmol/L, 49.6 U/L]. The differences were statistically significant(u = 9.93,15.23, T = 44954,48792.5, P ＜ 0.05)between the two groups. The factors of the older, higher FT3 and TRAb, longer duration, Graves disease (OR =1.751,1.470,1.483,1.445,1.234) increased the risk of HHD. Conclusions Graves disease, longer duration, old age, higher FT3 and TRAb are the risk factors of HHD. Timely prevention and control of risk factors is necessary to reduce the incidence of HHD.