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JCEM:缺血性心脏病患者非甲状腺疾病综合征和甲状腺功能减退症

2020-05-27 MedSci原创 MedSci原创

伴有NTIS或甲状腺功能减退的IHD患者与较高的全因死亡和MACE风险相关。需要进一步的研究以提供因果关系的证据,并阐明使甲状腺功能参数正常化是否可以改善患者预后。

非甲状腺疾病综合征(NTIS)和甲状腺功能减退与缺血性心脏病(IHD)患者预后之间的关系尚无定论。近日,内分泌和代谢性疾病领域权威杂志Journal of Clinical Endocrinology & Metabolism上发表了一篇研究文章,研究人员旨在评估NTIS和甲状腺功能减退对IHD患者全因死亡率和主要不良心脏事件(MACE)的影响。

研究人员检索了PubMed、EMBASE、Scopus、Web of Science和Cochrane图书馆,检索时间为数据库成立至2020年2月17日。研究人员选择研究的标准为招募IHD患者,并比较了NTIS和甲状腺功能减退患者的全因死亡率和MACE,且提供足够的信息进行荟萃分析。研究人员提取了相关信息和数值数据以进行方法学评估和荟萃分析。

该分析纳入了二十三项研究,伴有NTIS的IHD患者与较高的全因死亡率[风险比(HR)=2.61; 95%置信区间(CI)=1.89-3.59]和MACE(HR=2.22; 95%CI=1.71-2.89)风险相关。此外,甲状腺功能减退的IHD患者全因死亡(HR=1.47;95%CI=1.10-1.97)和MACE(HR=1.53;95%CI=1.19-1.97)的风险也较高。在亚组分析中,伴有NTIS的ACS亚组与全因死亡(HR=3.30; 95%CI=2.43-4.48)和MACE(HR=2.19; 95%CI=1.45-3.30)的较高风险相关。甲状腺功能减退的ACS亚组也与更高的全因死亡风险相关(HR=1.67;95%CI=1.17-2.39)。

由此可见,伴有NTIS或甲状腺功能减退的IHD患者与较高的全因死亡和MACE风险相关。需要进一步的研究以提供因果关系的证据,并阐明使甲状腺功能参数正常化是否可以改善患者预后。

原始出处:

Chun-Yu Chang,et al.Non-thyroidal illness syndrome and hypothyroidism in ischemic heart disease population: Systematic review and meta-analysis.JCEM.2020.https://doi.org/10.1210/clinem/dgaa310

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    2021-03-31 achengzhao
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