摘要： 目的 探讨低T3综合征对慢性心力衰竭（简称心衰）患者临床预后的影响。方法 回顾性分析慢性心衰患者7 780例，根据患者入院后检测的甲状腺功能，将其分为低T3综合征组和甲状腺功能正常组。采用多因素Cox回归分析低T3综合征与心衰患者临床预后的关系。受试者操作特征（ROC）曲线确定T3预测1年内死亡的最佳界值。采用Kaplan-Meier生存分析2组患者1年内的死亡情况，评估低T3综合征对心衰患者预后的影响。结果 与甲状腺功能正常组相比，低T3综合征组平均年龄、氨基末端脑钠肽前体（NT-proBNP）、尿素氮、肌酐、尿酸、血钾、心肌肌钙蛋白Ⅰ（cTNⅠ）水平较高；随着纽约心脏病协会（NYHA）心功能分级的增加，NT-proBNP水平逐级升高，游离三碘甲状腺原氨酸（FT3）水平逐级下降。多因素Cox回归分析结果显示，低T3综合征为心衰患者死亡的独立危险因素（HR=1.381，95%CI：1.185~1.608）。结论 低T3综合征是慢性心衰患者发生1年内死亡的独立危险因素。

低T3综合征对心力衰竭患者预后的影响

关琳, 王传合, 孙志军

中国医科大学附属盛京医院心内科, 沈阳 110022

收稿日期:2021-10-19出版日期:2022-09-30发布日期:2022-09-03
通讯作者:孙志军E-mail:sunzj_99@163.com
作者简介:关琳（1998-），女，硕士研究生.
基金资助:辽宁省自然科学基金（2018225003）


关键词: 慢性心力衰竭, 低T3综合征, 甲状腺激素, 预后
Abstract: Objective To investigate the influence of low T3 syndrome on clinical prognosis of patients with chronic heart failure(abbreviated as heart failure). Methods We performed a retrospective analysis of 7 780 patients with chronic heart failure. According to a thyroid function detected after admission, the patients were divided into low T3 syndrome group and normal thyroid function group. Multivariate Cox regression was used to analyze the relationship between the low T3 syndrome and clinical prognosis of patients with heart failure. The receiver operating characteristic curve was used to determine the optimal threshold for T3 to predict death within one year, and to assess the impact of low T3 syndrome on the prognosis of patients with heart failure. Results Compared with the normal thyroid function group, average age in the low T3 syndrome group, N-terminal pro-B type natriuretic peptide(NT-proBNP), urea nitrogen, creatinine, uric acid, serum potassium, and cardiac troponinⅠ levels were higher. With increase in the New York Heart Association grades, NT-proBNP levels gradually increased. The level of free triiodothyronine declines gradually. Multivariate Cox regression analysis found that low T3 syndrome(HR=1.381, 95% CI:1.185-1.608) was an independent risk factor for death in patients with heart failure. Conclusion Low T3 syndrome is an independent risk factor for death within one year in patients with chronic heart failure.
Key words: heart failure, low T3 syndrome, thyroid hormone, prognosis
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