老年2型糖尿病患者血清促甲状腺激素水平及其与冠脉病变程度的相关性分析

目的:探讨老年2型糖尿病(T2DM)患者血清促甲状腺激素(TSH)水平及其与患者冠脉病变程度的相关性。方法:回顾性分析2015年6月～2017年6月我院收治的88例老年T2DM患者(T2DM组)、50例健康体检者(对照组)的临床资料,根据血清TSH水平将T2DM组分为四个亚组,A组(0.45～1.49 m IU/L,n=18)、B组(1.50～2.49 m IU/L,n=23)、C组(2.50～3.49 m IU/L,n=22)、D组(≥4.5 m IU/L,n=25)。比较T2DM组与对照组TSH水平的差异,并根据计算机断层血管造影(CTA)结果计算Gensini评分,分析Gensini评分与血清TSH水平的相关性。结果:T2DM组血清TSH水平显著高于对照组,且随着血清TSH水平的升高,T2DM患者的年龄、TC、TG、LDL-C明显增加,而HDL-C、T3明显降低(P0.05)。C组病变支数显著多于A组,重度病变的比例明显升高,而D组病变支数、病变程度与A组、B组、C组比较差异均有统计学意义(P0.05)。血清TSH水平与Gensini评分呈显著正相关(r=0.577,P0.05)。结论:老年T2DM患者血清TSH水平显著升高,且与患者冠脉病变严重程度呈显著正相关,血清TSH水平有助于评估老年T2DM患者冠脉病变的严重程度。

Serum Thyroid Stimulating Hormone Level in Elderly Patients with Type 2 Diabetes and Its Correlation with the Severity of Coronary Artery Disease

ABSTRACT Objective: To explore the serum thyroid stimulating hormone level in elderly patients with type 2 diabetes(T2DM), and analyze its correlation with the severity of coronary artery disease. Methods: The clinical data of 88 cases of elderly patients with T2DM(T2DM group) and 50 cases of healthy control (control group) who admitted in our hospital from June 2015 to June 2017 were retrospec- tively analyzed. All the patients in T2DM group were assigned into 4 subgroups according to serum TSH levels: Group A (0.45-1.49 mIU/L), B(1.50-2.49 mIU/L), C(2.50-3.49 mIU/L), D(3.50-4.49 mIU/L). The change of serum level of TSH was compared between T2DM group and control group, and the Gensini score was calculated according to the results of computed tomography angiography (CTA), the corre- lation between Gensini score and serum TSH level was analyzed. Results: The serum TSH level in T2DM group was significantly higher than that of the control group, with the increase of serum TSH level, the age, TC, TG, LDL-C levels in T2DM patients were significantly increased, and HDL-C, T3 levels were obviously decreased(P<0.05). The number of diseased coronary vessels of group C was signifi- cantly more than that in group A, the proportion of severe lesion was significantly increased, and there was significantly difference on the number of diseased coronary vessels, lesion degree in group D compared with group A, group B and group C (P<0.05). The level of serum TSH was significantly positive correlated with the Gensini score (r=0.577, P<0.05). Conclusion: The serum TSH level of elderly patients with T2DM remarkably rised, and it was closely related to the severity of coronary artery lesions. Serum TSH level can contri- bute to assess the severity of coronary artery lesions in elderly patients with T2DM.