Observation And Analysis Of Thyroid Function In Patients With Different Types Of Coronary Heart Disease

Objective: to observe the thyroid function in patients with different types of coronary heart disease and to explore the interaction between thyroid hormone and the occurrence,type and severity of coronary heart disease.Research object: 606 patients(462 males and 144 females)who were hospitalized in the first affiliated Hospital of Guangxi Medical University from August 2018 to August 2019 underwent coronary angiography for the first time.The related clinical data were collected: sex,age,height,weight,serum T3,T4,FT3,FT4,TSH,CK,BNP,hs-CRP,serum troponin I,hypersensitive troponin T,TC,TG,HDL-C,LDL-C,EF and coronary angiography.The data of sex,age,height,weight,serum FT3 and FT4 were collected from 294 healthy people who had undergone thyroid function test in the physical examination department of our hospital in the same period(male 260,34 female)as the control group.Research methods: 1.The clinical data of coronary heart disease group and control group were compared and analyzed,including age,sex,BMI,FT3 and FT4.The occurrence of coronary heart disease was taken as dependent variable and sex,FT3 and FT4 as independent variables,Binary Logistic regression analysis was performed.2.The patients with coronary heart disease were divided into CAD group and ACS group according to the severity of the disease.The relevant clinical data of the two groups were compared and analyzed.The severity of the disease was taken as the dependent variable,and T3,T4,FT3,FT4,TSH,CK and serum troponin I as independent variables were analyzed by binary Logistic regression analysis.3.All patients with coronary heart disease were divided into low group(Gensini score≤40)and high group(Gensini score>40)according to whether the Gensini score of coronary angiography was more than 40.The relevant clinical data of the two groups were compared and analyzed,and the correlation between Gensini score and T3,T4,FT3,FT4,TSH and blood lipids was analyzed by pearson.4.The patients with acute coronary syndrome were divided into STEMI group and NSTEACS group according to the electrocardiogram.The relevant clinical data of the two groups were compared and analyzed.The type of acute coronary syndrome was taken as dependent variable,and sex,age,T3,FT3,T4,FT4,TSH,HDL-C,CK,EF,serum troponin I and BNP as independent variables were analyzed by binary Logistic regression analysis.Results: 1.There were statistically significant differences in gender,FT3,FT4 and TSH between the CHD group and the control group.Serum FT3,FT4 and TSH levels in CHD patients were lower than those in the control group,and women were more prone to CHD,while the differences in age and BMI were not statistically significant.Logistic regression analysis showed that FT3,FT4 and TSH were protective factors for CHD,and middle-aged and elderly women were more likely to develop CHD than middle-aged and elderly men.2.There were significant differences in CK between CAD group and ACS group.Compared with CAD group,ACS group had higher level of CK.Logistic regression analysis showed that ACS group had higher level of serum troponin I than CAD group.Patients with high serum troponin I were more likely to develop ACS,.T3,T4,FT3,FT4,TSH and CK had no effect on acute and chronic types of coronary heart disease.3.According to the Gensini score,there were significant differences in EF,T3,CK,BNP and LDL-C between the high and low groups.The high Gensini group showed lower EF and T3 levels,and higher CK,BNP and LDL-C levels.Pearson correlation analysis showed that T3,FT3,HDL-C were negatively correlated with Gensini scores,while LDL-C was positively correlated with Gensini scores.4.There were significant differences in sex,age,EF,T3,FT3,CK,serum troponin I,BNP,Hs-CRP,HDL-C between NSTEACS group and STEMI group.Age,EF,T3,FT3,HDL-C were lower,CK,serum troponin I,BNP,Hs-CRP were higher in STEMI group.Men were more likely to develop STEMI;than women.Binary Logistic regression analysis showed that the levels of T3,FT3 and serum troponin I in STEMI group were lower than those in NSTEACS group,and men were more likely to develop STEMI than women.Conclusion: 1.Patients with coronary heart disease showed lower thyroid hormone levels and TSH levels than healthy people.2.In the population with coronary heart disease,the more severe the coronary heart disease is,the lower the thyroid hormone level is.3.Patients with coronary heart disease with significantly reduced T3 may indicate a poor clinical prognosis.