关键词:

冠心病, 病情严重程度, 甲状腺功能, 病变支数, 相关性分析

Abstract:

Objective　To observe the influence of abnormal thyroid function on the severity of ICU patients with coronary heart disease and its correlation with the number of coronary artery lesions. Methods　A retrospective study was conducted on 113 patients with coronary heart disease who were admitted to ICU, First Hospital, Nanyang Medical College from January 2021 to June 2022. According to the results of thyroid function examination, 43 patients with normal thyroid function were classified as a normal group, 35 patients with hyperthyroidism as a hyperthyroidism group, and the remaining 35 patients with hypothyroidism as a hypothyroidism group. The disease incidences, Gensini scores of coronary artery disease, and the proportions of the patients with different severity of coronary heart disease were compared between the three groups. The receiver operator characteristic curve (ROC) was drawn to validate thyroid function as the disease severity predictor. According to the numbers of lesions, the patients with only 1 lesion branch were classified as group A, the patients with 2 lesion branches as group B, and the patients with 3 lesion branches as group C; the thyroid function test results were compared between the three groups. The Spearman correlation coefficient was used to verify the correlation between thyroid function and lesion numbers. χ², t, and F tests were used. Results　The score of Visual Analogue Scale (VAS), the frequency of attacks, the duration of pain, the degree of coronary stenosis, and the Gensini score of the hypothyroidism group were (5.25±1.41), (4.14±1.25) times/day, (5.41±1.38) min, (68.12±10.46)%, and (35.25±5.47), which were higher than those in the hyperthyroidism group [(4.12±1.35), (3.04±0.13) times/day, (4.29±0.73) min, (60.21±10.44)%, and (32.44±5.48)] and those in the normal group [(3.92±0.48), (2.23±0.45) times/day, (3.11±0.46) min, (53.77±10.63)%, and (28.35±5.25)], with statistical differences (F=14.98, 62.28, 61.50, 17.95, and 16.22; all P<0.05). The proportion of the patients with severe coronary heart disease in the hypothyroidism group was 68.57% (24/35), which was higher than those in the hyperthyroidism group [34.29% (12/35)] and the normal group [23.26% (10/43)], with a statistical difference (χ²=45.825,P<0.05). The ROC showed that as the TSH level increased, the T3 and T4 levels decreased, and conditions of the ICU patients with coronary heart disease gradually worsened. The TSH level in group C was (8.27 ± 2.33) mU/L, which was higher than those in group B [(6.62±2.33) mU/L] and group A [(4.41±1.28) mU/L]; the T3 and T4 levels in group C were (0.72±0.11) nmol/L and (3.71±0.37) μg/dL, which were lower than those in group B [(1.25±0.36) nmol/L and (5.15±1.88) μg/dL] and group A [(2.05±0.41) nmol/L and (7.44±2.12) μg/dL]; there were statistical differences (F=30.48, 155.25, and 46.43; all P<0.05). The Spearman correlation coefficient test showed that the number of coronary lesion branches in the ICU patients with coronary heart disease increased with the TSH level and as the T3 and T4 levels decreased. Conclusions　Hypothyroidism can exacerbate the severity in ICU patients with coronary heart disease; the TSH level is positively correlated with the number of lesions, while the T3 and T4 levels negatively with the number of lesions.

Key words:

Coronary heart disease, Severity of conditions, Thyroid function, Number of lesion branches, Correlation analysis