中文摘要：

目的 探讨非心肌梗死冠心病患者中非甲状腺病态综合征（non-thyroidal illness syndrome,NTIS）及FT3水平与远期全因、心血管死亡率的关系.方法 入选1 354例行冠脉造影的患者,经筛选后最终纳入984例经冠脉造影明确诊断的非心肌梗死冠心病患者,分为NTIS组和甲状腺功能正常组,按FT3三分位数（Tertile）分为T1、T2、T3组.研究随访1～6年,采用多因素Cox回归分析,比较FT3水平与非心肌梗死冠心病患者远期全因及心血管死亡率的关系.结果 984例非心肌梗死冠心病患者中129例存在NTIS.远期随访结果显示,随着FT3水平降低,全因死亡率（T1组为9.6％,T2组为11.5％,T3组为20.9％,P＜0.01）及心血管死亡率（T1组为4.5％,T2组为7.2％,T3组为11.0％,P＜0.01）均逐渐增高.经过各因素校正,FT3（HR=0.614,95％ CI0.439 ～0.859）与全因死亡独立相关.FT3（HR=0.605,95％ CI0.370～0.986）也是心血管死亡的独立危险因子.结论 NTIS存在于非心肌梗死冠心病患者,FT3降低为影响非心肌梗死冠心病患者远期全因死亡及心血管死亡的独立危险因素.

英文摘要：

Objective To determine the prognostic significance of non-thyroidal illness syndrome（NTIS） and FT3 on long-term all-cause and cardiovascular mortality in patients with coronary artery disease（CAD）.Methods A total of 1 354 patients underwent coronary angiograhy and participated in the study.After screening,984 patients with CAD were enrolled finally and divided into NTIS group and euthyroid group.The admitted patients were also classified into Tertile 1-3 groups based on FT3 value.The relationship of long-term all-cause and cardiovascular mortality with FT3 was investigated by multivariate Cox regression analysis.Results 129 out of 984 patients had NTIS.As FT3 value decreased,both long-term all-cause mortality （Tertile 1 group 9.6%,Tertile 2 group 11.5%,Tertile 3 group 20.9%,P〈0.01） and cardiovascular mortality （Tertile 1 group 4.5 %,Tertile 2 group 7.2%,Tertile 3 group 11.0%,P〈0.01） gradually increased.After adjusting for all factors,FT3 （HR =0.614,95% CI 0.439-0.859）was independently associated with long-term all-cause mortality.FT3 （HR =0.605,95% CI 0.370-0.986）was also a risk factor for cardiovascular mortality.Conclusion NTIS exists in patients with CAD without myocardial infarction.FT3 reduction is an independent risk factor for long-term all-cause and cardiovascular mortality in patients with CAD.