【摘要】 目的探讨慢性心力衰竭（chronic heart failure,CHF）患者甲状腺激素水平与远期生存率的相关性。方法入选355例CHF患者,入院后测定甲状腺激素水平、血糖血脂、行心脏超声检查并进行远期随访,比较各组指标并分析远期生存率。结果将人群FT₃值分为4分位数,位于下1/4位点者的住院时间、白细胞、中性粒细胞百分比、尿酸、肌酐、促甲状腺激素（thyroid stimulating hormone,TSH）明显高于上1/4位点者（P<0.05）,而红细胞、总蛋白、白蛋白、三酰甘油（triglyceride,TG）、左室射血分数（left ventricular ejection fraction,LVEF）、游离甲状腺素（FT₄）、血清钠、血清钙明显低于上1/4位点者（P<0.05）。Cox模型分析显示,在校正多因素后,游离三碘甲状腺原氨酸（FT₃）是影响CHF患者全因死亡率和心源性死亡率的独立危险因子,FT₃每下降1 pmoL/L,死亡风险增加49.8%,其次是LVEF和年龄。结论 FT₃是影响CHF患者全因死亡率和心源性死亡率的独立危险因子,低FT₃状态与慢性心力衰竭患者远期生存率相关。更多还原

【Abstract】 Objective To evaluate the correlation between thyroid hormone levels and long-time survival in patients with chronic heart failure（CHF）.Methods A total of 355 CHF patients were included in this study.Thyroid hormone profile,serum lipid and glucose were measured, echocardiography was examined.The correlation of thyroid hormone levels with long-time survival was analyzed.Results Quartiles of serum free triiodothyronine（FT₃） levels were computed.Compared with those in the highest quartile of FT₃,length of hospital stay,WBC,neutrophils percentage,uric acid,serum creatinine and TSH were higher in the lowest quartile group（P<0.05）,but RBC,total protein,albumin,triglyceride（TG）,left ventricular ejection fraction（LVEF）,FT₄,serum sodium and serum calcium were lower（P <0.05）.Cox regression displayed that FT₃ was an independent factor associate with all-cause mortality and cardiac mortality,followed by LVEF and age.An decrease of 1pmol/L in FT₃ was associated with an increase in mortality risk of 49.8%.Conclusion FT₃ is an independent risk factor for all-cause and cardiac mortality and low FT₃ state is related to long-time survival in chronic heart failure patients.更多还原