本文選題：冠心病 + 亞臨床甲狀腺功能減退癥�。� 參考：《山西醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:研究冠心病合并亞臨床甲狀腺功能減退癥(SCH)患者的臨床資料、冠脈造影特點及預(yù)后。方法:選取2015年10月~2016年4月在山大一院心血管內(nèi)科行冠狀動脈造影(CAG)確定為冠心病(CHD)的患者369例,根據(jù)冠心病是否合并有亞臨床甲狀腺功能減退癥將其分為兩組:冠心病亞甲減組(CHD+SCH組,101例),冠心病組(CHD組,268例),分別記錄這369例患者的臨床基本資料、冠脈造影特點(冠脈病變支數(shù)、部位、狹窄程度、彌漫性、Gensini評分)以及隨訪出院6個月后MACE事件的發(fā)生情況(再發(fā)心絞痛、重復(fù)PCI、心力衰竭、卒中、心因性死亡)。應(yīng)用統(tǒng)計學(xué)方法對這些數(shù)據(jù)進(jìn)行整理分析,觀察比較兩組患者在臨床、冠脈造影的特點以及預(yù)后方面是否有統(tǒng)計學(xué)差異。結(jié)果:(1)在冠心病亞甲減組中,女性患者比例顯著高于CHD組(P0.001),有吸煙史的比例明顯低于CHD組(P0.001),且合并高血壓(72.3%)、頸動脈硬化斑塊者(54.5%)比例明顯高于CHD組(60.1%、35.4%,P均0.05);(2)與CHD組比較,冠心病亞甲減組總膽固醇[TC,(4.71±1.46)比(4.24±1.09)mmol/L]、低密度脂蛋白膽固醇[LDL-C,(2.70±0.87)比(2.43±0.92)mmol/L]、載脂蛋白B[APOB,(0.87±0.25)比(0.80±0.23)mmol/L]、血小板體積分布寬度[PDW,(17.06±0.59)比(16.85±0.71)%]、纖維蛋白原定量[FIB,(3.93±0.91)比(3.61±0.89)g/L]水平明顯升高(P均0.05);(3)冠脈造影結(jié)果顯示:兩組患者冠狀動脈病變特點無顯著差異(P0.05)。(4)兩組患者6個月后主要心血管不良事件(MACE事件)發(fā)生率的差異無統(tǒng)計學(xué)意義(P0.05)。結(jié)論:冠心病合并亞臨床甲狀腺功能減退癥(SCH)患者頸動脈斑塊發(fā)生率高,且多合并有高血壓、血脂代謝紊亂以及凝血異常等多種心血管危險因素,應(yīng)積極干預(yù)以延緩動脈粥樣硬化(AS)性疾病的發(fā)生。
[Abstract]:Objective: to study the clinical data, coronary angiography and prognosis of patients with coronary heart disease complicated with subclinical hypothyroidism. Methods: from October 2015 to April 2016, 369 patients who underwent coronary angiography (CAG) in the Department of Cardiovascular Medicine of the first Hospital of Shanshan University were selected and identified as coronary heart disease (CHD). According to whether coronary heart disease is complicated with subclinical hypothyroidism, it is divided into two groups: subhypothyroidism coronary heart disease (CHD) subhypothyroidism group (n = 101) and coronary heart disease (CHD) group (n = 268). The characteristics of coronary angiography (number of coronary lesion branches, site, degree of stenosis, Gensini score of diffuse stenosis) and MACE events (recurrent angina pectoris, repeated PCI, heart failure, stroke, cardiogenic death) and 6 months after discharge from hospital. Statistical methods were used to analyze these data and to observe whether there were statistical differences in clinical features and prognosis between the two groups. Results the percentage of female patients with subthyroidism of coronary heart disease was significantly higher than that of CHD group (P 0.001), the proportion of patients with smoking history was significantly lower than that of CHD group (P 0.001), and the proportion of patients with hypertension 72.3%, carotid atherosclerotic plaques 54.5%) was significantly higher than that of CHD group (60.1% P 0.05) and CHD group. 鍐犲績鐥呬簹鐢插噺緇勬，

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