甲亢患者左心功能障碍发生与血清25羟维生素D BNP的关系

doi:10.3969/j.issn.1006-6233.2023.05.019

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摘要 目的:探讨甲亢患者左心功能障碍发生情况及与血清25羟维生素D[25(OH)D]、脑钠肽(BNP)水平的关系。方法:选取2021年1月至2022年6月在我院治疗的甲亢合并左心功能障碍患者71例(观察组),其中左心室收缩功能障碍患者41例,左心室舒张功能障碍30例,同时选取单纯甲亢患者71例(对照组),比较各组临床资料差异,同时分析左心室收缩功能障碍和左心室舒张功能障碍患者超声心动图参数差异。结果:观察组甲亢病程为(21.32±3.48)月,明显高于对照组(P<0.05);观察组BNP为(2.81±0.72)ng/L,明显高于对照组(P<0.05),而25(OH)D为(15.12±4.22)ng/mL,明显低于对照组(P<0.05)。观察组左心室收缩功能障碍患者BNP为(2.98±0.60)ng/L,明显高于舒张功能障碍患者(P<0.05),而25(OH)D分别为(13.83±3.11)ng/mL,明显低于左心室舒张功能障碍患者P<0.05)。25(OH)D与LVEF呈正相关(r=0.665,P<0.05);BNP与LVEF呈负相关(r=-0.759,P<0.05),而与E/A呈正相关(r=0.787,P<0.05)。25(OH)D、BNP诊断左心功能障碍的ROC曲线下面积分别为0.837、0.951,P<0.05。结论:甲亢合并左心功能障碍发生患者BNP水平明显升高,25(OH)D明显降低,在诊断左心功能障碍方面有一定应用价值。

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关键词 ：甲亢, 左心功能障碍, 血清25羟维生素D, 脑钠肽

Abstract：Objective: To investigate the occurrence of left ventricular dysfunction in patients with hyperthyroidism and its relationship with serum levels of 25 hydroxyvitamin D [25 (OH) D], brain natriuretic peptide (BNP). Methods: 71 patients with hyperthyroidism combined with left ventricular dysfunction treated in our hospital from January 2021 to June 2022 (observation group) were selected, including 41 patients with left ventricular systolic dysfunction and 30 patients with left ventricular diastolic dysfunction. At the same time, 71 patients with simple hyperthyroidism (control group) were selected. The differences in clinical data of each group were compared, and the differences in echocardiographic parameters of patients with left ventricular systolic dysfunction and left ventricular diastolic dysfunction were analyzed. Results: The course of hyperthyroidism in the observation group was (21.32 ± 3.48) months, which was significantly higher than that in the control group (P<0.05). BNP in the observation group was (2.81± 0.72) ng/L, which was significantly higher than that in the control group (P<0.05), while 25 (OH) D was (15.12 ± 4.22) ng/ml, respectively, which were significantly lower than that in the control group (P<0.05). BNP of patients with left ventricular systolic dysfunction was (2.98 ± 0.60) ng/L, which was significantly higher than that of patients with diastolic dysfunction (P<0.05), while 25 (OH) D were (13.83 ± 3.11) ng/ml, which were significantly lower than those of patients with left ventricular diastolic dysfunction (P<0.05). 25 (OH) D was positively correlated with LVEF (r=0.665, P<0.05); BNP was negatively correlated with LVEF (r=-0.759, P<0.05), but positively correlated with E/A (r=0.787, P<0.05). The ROC area under the curve diagnosised by 25 (OH) D, BNP for left ventricular dysfunction were 0.837 and 0.951, respectively, P<0.05. Conclusion: In patients with hyperthyroidism and left ventricular dysfunction, the BNP level increase significantly, and 25 (OH) D decrease significantly, which has certain application value in diagnosis left ventricular dysfunction.

Key words： Hyperthyroidism Left ventricular dysfunction Serum 25 hydroxyvitamin D Brain natriuretic peptide

基金资助:湖北省卫生健康委员会科研项目,(编号:WJ2018F038)

引用本文:

宋惠杰, 李阳, 肖方喜, 谭燚, 何旭梅. 甲亢患者左心功能障碍发生与血清25羟维生素D BNP的关系[J]. 河北医学, 2023, 29(5): 794-799.
SONG Huijie, LI Yang, XIAO Fangxi, et al. Relationship between Left Ventricular Dysfunction and Serum Levels of 25 Hydroxyvitamin D D-Dimer and APTT in Patients with Hyperthyroidism. HeBei Med, 2023, 29(5): 794-799.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2023.05.019 或 http://www.hbyxzzs.cn/CN/Y2023/V29/I5/794