急性心肌梗死合并亚临床甲减112例临床分析

【目的】研究急性心肌梗死合并亚临床甲状腺功能减退症（简称亚临床甲减）患者与急性心肌梗死合并甲状腺功能正常患者血脂水平、同型半胱氨酸（Hcy）水平、B型脑钠肽前体（Pro-BNP）水平以及心功能之间的差异。【方法】选择2011年1月至2013年5月在湖南省人民医院心内科住院患者224例，并分为急性心肌梗死合并亚临床甲减组（A组，n ＝112）及急性心肌梗死合并甲状腺功能正常组（B组，n ＝112），均空腹抽血行促甲状腺激素（TSH）、甘油三酯（TG）、总胆固醇（TC）、Hcy、Pro-BNP检测，心脏彩超测定左室射血分数（LVEF），并比较两组指标的差异。【结果】与B组相比，A组患者血清TSH、TC、TG、Hcy、Pro-BNP均升高，同时LVEF值降低，差异有显著统计学意义（ P ＜0．05或 P ＜0．01）。【结论】亚临床甲减影响血脂代谢、损害血管内皮功能，并与T C、血浆H cy存在一定相关性，为心肌梗死的独立危险因素。

Clinical Analysis of 112 Patients with Acute Myocardial Infarction and Subclinical Hypothy-roidism

[Objective]To explore the difference of blood lipid ,homocysteine（Hcy） ,B-type brain natri-uretic peptide（Pro-BNP） and cardiac function between acute myocardial infarction patients with subclinical hy-pothyroidism （SH） and acute myocardial infarction patients with normal thyroid function .[Methods] Totally 224 inpatients in Hunan provincial People＆#39;s hospital from Jan .2011 to May 2013 were chosen and divided into acute myocardial infarction with SH group （group A ,n = 112） and acute myocardial infarction with normal thyroid function group（group B ,n = 112） .Fasting blood samples were drawn to detect thyroid stimulating hormone（TSH） ,triglycerides（TG） ,total cholesterol（TC） ,homocysteine（Hcy） and Pro-BNP .Cardiac color echocardiography was performed to measure left ventricular ejection fraction （LVEF） .The difference of the in-dexes between two groups was compared .[Results]Compared with group B ,serum levels of TSH ,TC ,TG , Hcy and Pro-BNP in group A were increased ,while LVEF was decreased ,and there were significant differ-ences（ P〈0 .05 or P 〈0 .01） .[Conclusion]SH can affect blood lipid metabolism and destroy the endothelial function ,and has a certain correlation with TC and plasma Hcy .Therefore SH is the independent risk factor of myocardial infarction .