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急性心肌梗死患者PCI术后血清TT3、FT3水平与主要不良心血管事件发生的关系

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摘要:

目的 探究急性心肌梗死(AMI)患者经皮冠脉动脉介入治疗(PCI)术后血清总三碘甲状
腺原氨酸(TT3)、游离三碘甲状腺原氨酸(FT3)水平与主要不良心血管事件(MACE)发生的关系。
方法 选取2017年1月至2020年6月于河南科技大学第一附属医院行PCI的急性ST段抬高型心肌梗死患者
310例为研究对象,根据术后24个月发生MACE情况分为MACE组(71例)和非MACE组(239例)。根据
TT3水平按四分位间距将AMI患者分为四组:A1组、B1组、C1组及D1组,根据FT3水平按四分位间距将
AMI患者分为四组:A2组、B2组、C2组及D2组。采用Kaplan-Meier法分析TT3和FT3与AMI患者MACE发
生率的关系。采用COX分析影响AMI患者PCI术后发生MACE的因素。结果 与非MACE组相比,MACE组
肌酐、尿酸、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)水平较高(P<0.05),心率、TT3、
FT3水平较低(P<0.05)。与A1组、B1组相比,C1组、D1组LDL-C水平、TC、肌酐水平较低,心率
较高(P<0.05);与A2组、B2组相比,C2组、D2组LDL-C水平、TC、肌酐水平较低,心率较高(P
<0.05)。K-M分析显示,A1组、B1组、C1组、D1组AMI患者术后MACE发生率,差异有统计学意义(P
<0.05)。A2组、B2组、C2组、D2组AMI患者术后MACE发生率,差异有统计学意义(P<0.05)。TT3
≤0.62 ng/ml、FT3≤2.82 pg/ml是AMI患者术后MACE发生的独立危险因素(P<0.05)。结论 AMI患者
PCI术后患者血清TT3、FT3水平与主要不良心血管事件具有密切关系。

Abstract:

Objective To explore the relationship between serum total triiodothyronine (TT3) and free
triiodothyronine (FT3) levels and the occurrence of major adverse cardiovascular events (MACE) in patients with acute
myocardial infarction (AMI) after percutaneous coronary intervention (PCI). Methods A total of 310 patients with acute
ST-segment elevation myocardial infarction who underwent PCI treatment in The First Affiliated Hospital of Henan
University of Science and Technology from January 2017 to June 2020 were selected as the research objects. The patients
were divided into MACE group (71 cases) and non-MACE group (239 cases) according to the occurrence of MACE at 24
months after operation. According to the TT3 level, the AMI patients were divided into four groups, A1 group, B1 group,
C1 group and D1 group, according to the level of FT3, the patients with AMI were divided into four groups, A2 group, B2
group, C2 group and D2 group. The Kaplan-Meier method was used to analyze the relationship between TT3 and FT3
and the incidence of MACE in AMI patients. COX was used to analyze the factors influencing the occurrence of MACE in
AMI patients after PCI. Results Compared with the non-MACE group, the MACE group had higher levels of creatinine,
uric acid, total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) (P<0.05), and lower heart rate and levels
of TT3 and FT3 (P<0.05). Compared with A1 group and B1 group, C1 group and D1 group had lower levels of LDL-C,
TC and creatinine, and higher heart rate (P<0.05); compared with A2 group and B2 group, C2 group and D2 group had
lower levels of LDL-C, TC and creatinine, and higher heart rate (P<0.05). KM analysis showed that the incidence of
postoperative MACE in AMI patients with Group A1, Group B1, Group C1, Group D1, the difference was statistically
significant (P<0.05). The incidence of postoperative MACE in AMI patients with Group A2, Group B2, Group C2, Group
D2, the difference was statistically significant (P<0.05). TT3≤0.62 ng/ml and FT3≤2.82 pg/ml were independent risk
factors for postoperative MACE in patients with AMI (P<0.05). Conclusion Serum TT3 and FT3 levels in patients with
AMI after operation are closely related to major adverse cardiovascular events.

基金项目:

2020年度河南省医学科技攻关计划联合共建项目
(2001029A)

参考文献:

  • 2008

  • 1

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