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目的探讨急性冠脉综合征(ACS)患者甲状腺激素游离三碘甲状腺原氨酸(FT3)和反三碘甲状腺原氨酸(rT3)的变化及FT3与C反应蛋白(CRP)的关系。方法将155例ACS患者分为不稳定心绞痛(UAP)、急性ST段抬高性心肌梗死(STEMI)及急性非ST段抬高性心肌梗死(NSTEMI)3个亚组。选取同期经冠状动脉造影检查排除冠心病的患者为对照组,共67例。测定各组血清FT3、rT3和CRP等。结果 ACS组FT(33.92±0.72)pmol/L低于对照组(4.59±0.65)pmol/L,差别有统计学意义(P<0.01)。STEMI组FT(33.79±0.62)pmol/L、NSTEMI组FT(33.63±0.70)pmol/L低于UAP组(4.22±0.72)pmol/L,差别有统计学意义(P<0.05)。STEMI组与NSTEMI组之间FT3差别无统计学意义。ACS组血清rT(31.46±0.73)nmol/L高于对照组(0.76±0.18)nmol/L,NSTEMI组血清rT(33.63±0.70)nmol/L高于UAP组(4.22±0.72)nmol/L和STEMI组(3.79±0.62)nmol/L,差别均有统计学意义(P<0.05)。UAP组血清rT3与STEMI组间差别无统计学意义。ACS组血清CRP(8.23±8.63)mg/L高于对照组(3.60±3.87)mg/L,STEMI组血清CRP(10.41±9.80)mg/L高于UAP组(5.46±4.93)mg/L,差别均有统计学意义(P<0.01)。NSTEMI组血清CRP(9.18±10.20)mg/L介于UAP与STEMI组之间,但与两组的差别均无统计学意义。ACS患者FT3与CRP低度负相关(r=-0.161,P<0.05)。结论 ACS患者表现为低T3综合征,血清FT3、rT3水平测定对疾病严重程度判断有一定参考价值。ACS患者血清CRP升高,反映炎症在ACS的发生、发展过程中发挥一定的作用。FT3与CRP反应有低相关性,仍需进一步研究。
Objective To investigate the changes of free triiodothyronine (FT3) and anti-triiodothyronine (rT3) and the relationship between FT3 and C reactive protein (CRP) in patients with acute coronary syndrome (ACS). Methods 155 patients with ACS were divided into three subgroups: unstable angina pectoris (UAP), acute ST-elevation myocardial infarction (STEMI) and acute non-ST-segment elevation myocardial infarction (NSTEMI). Select the same period by coronary angiography to exclude coronary heart disease patients as control group, a total of 67 cases. Determination of serum FT3, rT3 and CRP and so on. Results The FT (33.92 ± 0.72) pmol / L in ACS group was lower than that in control group (4.59 ± 0.65) pmol / L, with statistical significance (P <0.01). FT (33.79 ± 0.62) pmol / L in STEMI group and 33.63 ± 0.70 pmol / L in NSTEMI group were lower than that of UAP group (4.22 ± 0.72) pmol / L, the difference was statistically significant (P <0.05). FT3 difference between STEMI group and NSTEMI group was not statistically significant. The serum rT (31.46 ± 0.73) nmol / L in ACS group was significantly higher than that in control group (0.76 ± 0.18) nmol / L, the serum rT (33.63 ± 0.70) nmol / L in NSTEMI group was significantly higher than that in UAP group STEMI group (3.79 ± 0.62) nmol / L, the difference was statistically significant (P <0.05). UAP group serum rT3 and STEMI difference between groups was not statistically significant. The level of serum CRP in ACS group was significantly higher than that in control group (8.23 ± 8.63 mg / L vs 3.60 ± 3.87 mg / L, 10.41 ± 9.80 mg / L vs 5.46 ± 4.93 mg / L in STEMI group, The differences were statistically significant (P <0.01). Serum CRP (9.18 ± 10.20) mg / L in NSTEMI group was between UAP and STEMI group, but there was no significant difference between the two groups. There was a low degree of negative correlation between FT3 and CRP in patients with ACS (r = -0.161, P <0.05). Conclusion ACS patients with low T3 syndrome, serum FT3, rT3 levels of determination of the severity of the disease have some reference value. ACS patients with elevated serum CRP, reflecting the occurrence of inflammation in the ACS, the development process to play a role. There is a low correlation between FT3 and CRP response, and further research is still needed.