低T3综合征与BNP在心血管疾病中的相关性与预后分析研究
摘要
目的探讨低T3综合征与B型脑纳肽(BNP)在心血管疾病中的相关性及其对远期生存率的影响。方法选择该院2014年1月至2016年1月收治的心血管疾病患者720例,排除甲状腺疾病史及影响甲状腺功能的用药史后,最终442例患者纳入研究,根据患者甲状腺功能检测指标水平分为低T3组和正常组。患者入院后测定甲状腺激素及BNP水平,行超声心动图检查,记录患者的临床信息,并进行远期随访,比较各组的指标并分析远期生存率。结果结果显示血清游离三碘甲状腺原氨酸(FT3)水平与年龄、lg(BNP)呈负相关(r=-0.275、-0.192,P=0.000、0.028),与射血分数呈正相关(r=0.368,P=0.000)。Kaplan-Meier曲线显示低T3组的死亡率明显高于正常组(P=0.000)。高BNP/低T3组的全因死亡率和心源性死亡率均明显高于其他各组(P=0.000),其余依次为高BNP/正常T3组、低BNP/低T3组及低BNP/正常T3组。结论 FT3和BNP的联合测定在心血管疾病严重程度及患者预后方面具有重要价值。
引文
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[22]MOURA NETO A,PARISI M C,ALEGRE S M,et al.Relation of thyroid hormone abnormalities with subclinical inflammatory activity in patients with type 1and type2diabetes mellitus[J].Endocrine,2016,51(1):63-71.
[23]SABBAGHZIARANI F,MORTEZAEE K,AKBARI M,et al.Stimulation of neurotrophic factors and inhibition of proinflammatory cytokines by exogenous application of triiodothyronine in the rat model of ischemic stroke[J].Cell Biochem Funct,2017,35(1):50-55.
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[2]CANTINOTTI M,WALTERS I H,CROCETTI M,et al.BNP in children with congenital cardiac disease:is there now sufficient evidence for its routine use?[J].Cardiol Young,2015,25(3):424-437.
[3]OUZAN E,KINDYA B,GONEN E,et al.Prognostic value of NT pro-BNP levels on mild to long term outcome after TAVI:a monocentric study[J].Regresar Al Número,2017,9(1):65-68..
[4]PARK C S,PARK J J,OH I Y,et al.Relation of renal function with left ventricular systolic function and NT-proBNP level and its prognostic implication in heart failure with preserved versus reduced ejection fraction:an analysis from the korean heart failure(KorHF)registry[J].Korean Circ J,2017,47(5):727-741.
[5]SKOCZYNSKA A,WOJAKOWSKA A,TURCZYN B,et al.Serum lipid transfer proteins in hypothyreotic patients are inversely correlated with Thyroid-Stimulating hormone(TSH)levels[J].Med Sci Monit,2016,22(4):4661-4669.
[6]NAGAI H,SATOMI T,ABIRU A,et al.Antihypertrophic effects of small molecules that maintain mitochondrial ATP levels under hypoxia[J].Ebiomedicine,2017,24(36):147-158.
[7]KISHIDA C,NAITO R,KASUYA H,et al.Heart failure with hyperthyroidism demonstrating discrepancy between the clinical course and b-type natriuretic peptide levels[J].Int Med,2018,57(12):1747-1749.
[8]FELIX N M,LEAL R O,GOY-THOLLOT I,et al.Effects of buprenorphine in the adrenal,thyroid,and cytokine intra-operative responses in a rat model(Rattus norvegicus):apreliminary study[J].Iran J Basic Med Sci,2017,20(4):368-379.
[9]JANSSEN R,MULLER A,SIMONIDES W S.Cardiac thyroid hormone metabolism and heart failure[J].Eur Thyroid J,2017,6(3):130-137.
[10]王春艳,冯玉宝,苏平.低T_3综合征与心血管疾病关系的研究进展[J].实用心脑肺血管病杂志,2016,24(12):4-6.
[11]牛伟华,李广平.慢性心力衰竭患者甲状腺激素水平与认知功能的相关性研究[J].天津医科大学学报,2016,15(1):21-23.
[12]CHIANEH Y R,VARASHREE B S,JOGI S,et al.Study of serum lipid profile of patients with high Thyroid-Stimulating hormone(TSH)in South Indian population[J].Adv Sci Lett,2017,23(3):1939-1942.
[13]ZHANG B W,PENG W H,WANG K,et al.Vaspin as a prognostic marker in patients with acute myocardial infarction[J].Heart Lung Circulation,2016,25(3):257-264.
[14]AFSAR B,YILMAZ M I,SIRIOPOL D,et al.Thyroid function and cardiovascular events in chronic kidney disease patients[J].J Nephrol,2017,30(2):235-242.
[15]HAYASHI T,HASEGAWA T,KANZAKI H,et al.Subclinical hypothyroidism is an Independent predictor of adverse cardiovascular outcomes in patients with acute decompensated heart failure[J].ESC Heart Fail,2016,3(3):168-176.
[16]余信强.老年慢性心力衰竭患者心功能与血清甲状腺激素、血浆N末端原脑利钠肽的变化及对预后的影响[J].海南医学院学报,2013,19(7):898-900.
[17]CAMPI I,CAMMARATA G,MARZOLI S B,et al.Retinal photoreceptor functions are compromised in patients with resistance to thyroid hormone syndrome(RTH beta)[J].J Clin Endocrinol Metab,2017,102(7):2620-2627.
[18]AMABILI P,BENBOUCHTA S,ROEDIGER L A,et al.Low cardiac output syndrome after adult cardiac surgery:predictive value of peak systolic global longitudinal strain[J].Anesth Analg,2018,126(5):1476-1483.
[19]潘秀玲,陈英,尹向辉.高血压病分级与甲状腺激素水平的关系分析[J].青海医药杂志,2015,58(11):18-19.
[20]MIN J K,PARK Y W,LIM S M.Complete recovery of perfusion abnormalities in a cardiac arrest patient treated with hypothermia:results of cerebral perfusion MR imaging[J].Invest Magn Reson Imag,2018,22(1):56-66.
[21]BURKAUSKAS J,BUNEVICIUS A,BROZAITIENE J,et al.Cognitive functioning in coronary artery disease patients:associations with thyroid hormones,N-Terminal Pro-B-Type natriuretic peptide and High-Sensitivity C-Reactive protein[J].Arch Clin Neuropsychol,2017,32(2):245-251.
[22]MOURA NETO A,PARISI M C,ALEGRE S M,et al.Relation of thyroid hormone abnormalities with subclinical inflammatory activity in patients with type 1and type2diabetes mellitus[J].Endocrine,2016,51(1):63-71.
[23]SABBAGHZIARANI F,MORTEZAEE K,AKBARI M,et al.Stimulation of neurotrophic factors and inhibition of proinflammatory cytokines by exogenous application of triiodothyronine in the rat model of ischemic stroke[J].Cell Biochem Funct,2017,35(1):50-55.
[24]BANERJEE D,UPADHYAY R C,CHAUDHARY U B,et al.Seasonal variations in physio-biochemical profiles of Indian goats in the paradigm of hot and cold climate[J].Biol Rhythm Res,2015,46(2):221-236.