云南地区慢性心力衰竭患者正常甲状腺功能病态综合征的流行病学调查

Prevalence of euthyroid sick syndrome in patients with heart failure in Yunnan Province

摘要:

目的了解云南地区慢性心力衰竭（CHF）患者正常甲状腺功能病态综合征（ESS）的流行病学特点，为该地区CHF 合并ESS 提供科学防治。方法选取2 560 例CHF 患者临床资料，剔除缺失数据共1083 例患者，分析CHF患者ESS 发生率的变化情况。结果CHF 患者ESS 发生率为25.4%，心功能Ⅱ级患者ESS 发生率为11.6%，心功能Ⅲ级为19.6%，心功能Ⅳ级为43.7%，比较差异有统计学意义（p <0.05）。与射血分数保留的心力衰竭（HFpEF）组心力衰竭患者比较，射血分数下降的心衰（HFrEF）组ESS 发生率更高（p <0.05）。随着年龄阶段的增长，ESS 发生率越高，差异有统计学意义（p <0.05）。CHF 患者中，男性ESS 发生率为26.5%，女性ESS 发生率 为24.6%，差异无统计学意义（p >0.05）。不同疾病所致CHF的ESS发生率各不相同，差异无统计学意义（p >0.05）。CHF 患者的年龄、心功能、BNP 和LVEDD值是ESS 发生率的危险因素（p <0.05），而LVEF 值是ESS 发生率的保护因素（p <0.01）。结论CHF患者合并ESS 发病率较高，其与年龄、心功能、LVEF 及LVEDD 有关，随着心功能越差，年龄越高，LVEF越低，LVEDD越大，ESS 发生率越高。

Abstract:

To explore the prevalence of euthyroid sick syndrome (ESS) in patients with chronic heart failure (CHF) in Yunnan Province. Methods The clinical data of 2,560 patients with CHF were collected and the patients who missed thyroid hormone (TH) were excluded. Finally, total 1,083 patients participated in this study. According to age, cardiac function of NYHA class and etiology, the prevalence of ESS in patients with CHF was investigated. Results ESS prevalence was 25.4% in patients with CHF, ESS prevalence of NYHA class Ⅱ, NYHA class Ⅲ, NYHA class Ⅳwere 11.6%, 19.6% and 43.7% respectively. The difference of ESS prevalence of these groups had statistical significance (p < 0.05). ESS prevalence of HFREF group was higher than that in HFPEF group (p < 0.05). ESS prevalence was increased with age growth, the difference had statistically significant (p < 0.05). ESS prevalence in female and male patients were 24.6%, 26.5% respectivelyThe difference of ESS prevalence of these groups had no statistical significance (p > 0.05). The difference of different etiology was not statistically significant (p > 0.05). Age, cardiac function, etiology, BNP, LVEDD of CHF patients wew risk factors for the incidence of ESS (p < 0.05), and LVEF was the protective factors (p <0.05). Conclusions The prevalence of ESS in patients with CHF are high in Yunnan Province, and the prevalence inceases with age growth, LVEDD increasing, LVEF decreasing, cardiac function worsening.