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急性心肌梗死(AMI)中的甲状腺功能减退和甲状腺自身免疫

Hypothyroidism and thyroid autoimmunity in acute myocardial infarction (AMI).

作者信息

Salabè G B, Salabè-Lotz H, Puletti M, Milani C

机构信息

Institute of Experimental Medicine, C.N.R., Rome.

出版信息

Thyroidology. 1989 Aug;1(2):67-72.

PMID:2484865
Abstract

It has been suggested that subjects with thyroid autoimmunity are more frequently affected by acute myocardial infarction (AMI), than the general population (Lancet ii, 155-158, 1977). Serum thyroid antibodies (microsomal and thyroglobulin) were measured in a cohort of 132 males admitted consecutively to the Coronary Unit of Clinica Medica II Univ. "La Sapienza" of Rome with AMI. In the AMI group the thyroid autoimmunity was twice as frequent as in an age matched random population (9.1 vs 17.4%), but the association was statistically weak (p less than 0.05). In the group over 60 y two cases of overt hypothyroidism were found and none in the control group. The prevalence of 2.5% is higher than that reported in previous surveys carried out in elderly populations. No differences have been demonstrated in concentration of serum cholesterol, triglycerides, apolipoprotein A and B between patients with and without thyroid autoimmunity, although the serum cholesterol of AMI patients and those with asymptomatic thyroiditis was significantly higher than that of the general population. It is concluded that the prevalence of thyroid autoimmunity and hypothyroidism are increased in AMI and migth thus contribute to development of hypercholesterolemia and/or immune mechanisms.

摘要

有人提出,患有甲状腺自身免疫的受试者比普通人群更易患急性心肌梗死(AMI)(《柳叶刀》第二卷,第155 - 158页,1977年)。对连续入住罗马第二大学“La Sapienza”临床医学院冠心病科的132名男性进行了血清甲状腺抗体(微粒体抗体和甲状腺球蛋白抗体)检测。在AMI组中,甲状腺自身免疫的发生率是年龄匹配的随机人群的两倍(9.1%对17.4%),但这种关联在统计学上较弱(p小于0.05)。在60岁以上的人群中发现了2例明显的甲状腺功能减退,而对照组未发现。2.5%的患病率高于先前在老年人群中进行的调查所报告的患病率。在有或没有甲状腺自身免疫的患者之间,血清胆固醇、甘油三酯、载脂蛋白A和B的浓度没有差异,尽管AMI患者和无症状甲状腺炎患者的血清胆固醇显著高于普通人群。得出的结论是,AMI患者中甲状腺自身免疫和甲状腺功能减退的患病率增加,因此可能促成高胆固醇血症和/或免疫机制的发展。

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