不稳定型心绞痛、心肌梗死患者甲状腺激素水平的测定及其临床意义

目的评价不稳定型心绞痛（UA）及急性心肌梗死（AMI）、陈旧性心肌梗死（OMI）患者血清甲状腺激素水平变化的临床意义。方法选择7l例正常人群为对照组，170例冠心病患者作为病例组，并分成三个亚组，其中患者52例，OMI患者50例，UA患者68例。测定血清甲状腺激素水平。结果AMI急性心肌梗死组与对照组相比血清总三碘甲状腺原氨酸（TT3）下降、游离三碘甲状腺原氨酸（FT3）下降有统计学意义（P〈0．01），总甲状腺素（TT4）、游离甲状腺素（FT4）水平有下降趋势。UA组与对照组比血清FT3下降有统计学意义（P〈0．05）。三个亚组间在单支、双支、多支血管病变间比较，血清TT3、FT3均呈下降趋势，AMI在多支病变时与UA、OMI相比血清FT3下降有统计学意义（P〈0．05）。结论患者血清TT3、FT3水平反应急性心肌梗死、不稳定型心绞痛病情及冠脉血管病变的严重程度，病情越严重，下降越明显。

Thyroid Hormone Level and its Clinical significance in Unstable Aangina and Myocardial Infarction

Objective To investigate the serum thyroid hormones levels in patients （pts） with unstable angina,acute myocardial infarction（AMI）,and old myocardial infarction. Methods One hundred and seventy pts were divided into three groups： Acute myo- cardial infarction （AMI,n=52 ）, old myocardial infarction （OMI, n = 50）, unstable angina （UA, n = 68）. Seventy subjects were as controls. Results Compared with the control group,the serum total triiodothyronine （TT3） was significantly decreased （P〈0.01）, the serum free thyroxine （FT3） was significantly decreased in pts with AMI （P〈0.01）, the serum total thyroxine （TT4）, and free thyroxine （FT4） levels were also lower in pts with AMI, but there was no significant difference （P〈0.05）. Compared with the control group, the serum FT3 was significantly decreased in UA group （P〈0.05）. Compared with the control group, the serum of TT3, FT3,TT4 and FT4 level in OMI group were not significant difference （P〉0.05）. Compared with UA, the serum FT3 in AMI with multivessel disease was significantly decreased （P〈0.05）. Compared with OMI, the serum FT3 in AMI with multivessel disease was significantly decreased （P〈0.01）. Conclusion The levels of serum TT3 and FT3 were decreased in patients with AM1, UA and OMI.