【摘要】 目的研究甲状腺激素对收缩功能下降的慢性心力衰竭患者房颤发生率的影响及相关的机制。方法入选181例收缩功能下降的慢性心力衰竭患者,入院后24 h内记录患者病史,测定血清游离甲状腺素(FT4)、游离三碘甲状腺原氨酸(FT3)、促甲状腺激素(TSH)、低密度脂蛋白(LDL)水平;并行十二导心电图及超声心动图检查,根据是否并发房颤分为房颤组和窦律组,分析影响心衰患者发生房颤的相关因素。结果 181例心衰患者中并发房颤102例(56.35%),房颤组与窦律组的FT4水(15.04±3.26)pmol/L比(13.27±2.61)pmol/L,P<0.001的差异有统计学意义,两组FT3水平差异(4.02±0.61)pmol/L比(4.26±1.14)pmol/L,P=0.078无统计学意义;FT4水平与左心房内径无明显相关性(r=0.105,P=0.160),FT3水平与年龄呈负相关(r=-0.286,P<0.001);FT4水平、左心房内径、年龄、心衰持续时间与心衰患者房颤发生率相关。结论高FT4水平可能增加了收缩功能下降的慢性心力衰竭患者发生房颤的风险。更多还原

【Abstract】 Objective To investigate the impact of thyroid hormone on atrial fibrillation( AF) prevalence ofchronic heart failurepatients who suffered from reduced ejection fraction( HFr EF) and its related mechanisms.Methods 181 patients with HFr EFwere enrolled in this study,medical history were recorded,profile of free triiodothyronine( FT3),free thyroxine( FT4),thyroid stimulating hormone( TSH) and low- density lipoprotein( LDL) were determined within 24 hours after admission. Meanwhile,ECG and Ultrasonic cardiogram were examined. The patients were divided into AF group and sinus rhythm group according to whether the AF occurred,and the related factors influencing the incidence of AF in patients with CHF were analyzed. Results Among the181 patients,102( 56. 35%) were complicated with AF,FT4 level of patients with AF were significantlyhigher than those of patients with sinus rhythm[15. 04 ± 3. 26 pmol / L vs 13. 27 ± 2. 61 pmol / L,P < 0. 001],but there was no significant difference of FT3 level between the two groups. FT4 level was not significantlyassociated with left atrial dimension( LAD)( r = 0. 105,P = 0. 160). FT3 level was negatively correlated with age( r =- 0. 286,P< 0. 001). FT4 level,LAD,age,CHF duration were associated with the incidence of AF in patients with HFr EF.Conclusions High FT4 level probably increases the risk of incidence of AF in patients with HFr EF.更多还原