Clinical study of predicting the occurrence and development of coronary heart disease by FT3 level in maintenance hemodialysis patients

摘要

Objective:To investigate the clinical significance of FT3 level in predicting the occurrence and development of coronary heart disease in maintenance hemodialysis patients.Methods:95 Patients who underwent maintenance hemodialysis in our hospital from January 2016 to December 2017 were selected as subjects. According to whether has coronary heart disease was divided into coronary heart disease group and non coronary heart disease group, the difference of FT3 level and related laboratory indexes was observed. ROC curve analysis and COX multiple factor risk regression were used to analyze the predictive value of FT3 level on the occurrence and development of heart disease in MHD patients.Results:The concentration of FT3, Hb and ALB in CHD group was lower than that of non-CHD group (P<0.05), and the content of TG, TC, LDL-C, Hcy and Hs-CRP were significantly higher than that of non-CHD group (P<0.05). FT3 was positively correlated with Hb and ALB (T=0.821, 0.809,P<0.05), and was negatively correlated with TG, TC, LDL-C, Hcy and Hs-CRP (T=- 0.814, - 0.843, - 0.904, - 0.806, - 0.912,P<0.05). The ROC curve analysis showed that the area of AUC of FT3 was the highest, 0.864 (95％, CI:0.803～0.935), the sensitivity and specificity was 86.5％ and 89.3％ respectively. The area of combined diagnosis of AUC was 0.904 (95％CI:0.867～0.976), the sensitivity and specificity was 85.6％ and 94.5％, respectively. After analyzing the COX risk regression model and correcting the above laboratory indicators, FT3 is an independent risk factor (HR: 0.58, 95％, CI: 0.41～0.72,P<0.05) for the adverse prognosis of MHD patients with coronary heart disease.Conclusion:It is of high clinical value to predict the development of coronary heart disease in MHD patients by FT3 level, and its mechanism may be related to the reduction of thyroxine synthesis, inflammatory reaction and atherosclerosis.