FT3对急性ST段抬高型心肌梗死行直接经皮冠脉介入治疗近期预后的价值探讨

发布时间：2018-06-14 06:44

本文选题：急性心肌梗死 + 甲状腺激素　；参考：《青岛大学》2014年硕士论文

【摘要】：目的分析接受直接经皮冠脉介入治疗(primary percutaneous coronary intervention, PCI)的急性ST段抬高型心肌梗死(ST-elevation myocardial infarction,STEMI)患者甲状腺激素水平对其近期预后评价的价值。方法连续入选甲状腺功能正常的行直接PCI的STEMI患者102例。于直接PCI后24小时内采集外周静脉血,测游离三碘甲状腺原氨酸(FT3),N末端脑钠肽前体(NT-proBNP)。根据FT3水平分为低FT3组(FT33.10pmol/L)和正常FT3组(FT3≥3.10pmol/L)。所有患者于发病5-7天内行心脏超声检查,测左室射血分数(LVEF%)反应患者心功能情况。所有患者随访6个月,记录随访期间的死亡情况。结果随访6个月,用Kaplan-Meier法评估两组之间死亡率并用Log-rank检验两组生存率差异是否有统计学意义,低FT3组共7人死亡、生存率为83.3%低于正常FT3组的96.5%(x2=4.493,P=0.034)。用线性回归分析FT3与LVEF%呈正相关(y=4.92+40.3, P0.001)。FT3与NT-proBNP呈负线性相关(y=-1905x+8839, P0.001)。用Pearson卡方检验比较两组患者的冠脉病变程度有显著性差异(P0.001)。结论本研究通过分析102名行直接PCI的STEMI患者,发现FT3水平与心肌梗死后心功能严重程度相关,低FT3的STEMI患者死亡率升高。FT3可以作为评价STEMI患者预后的指标。
[Abstract]:Objective to evaluate the value of thyroid hormone levels in patients with acute ST segment elevation myocardial infarction (ST-elevation myocardial infarction, STEMI) with primary percutaneous coronary intervention (PCI) for short-term prognosis evaluation.
Methods 102 cases of STEMI patients with normal thyroid function were selected for direct PCI. Peripheral venous blood was collected within 24 hours after direct PCI. Free three iodine thyroprosine (FT3) and N terminal brain natriuretic precursor (NT-proBNP) were measured. According to the FT3 level, there were low FT3 group (FT33.10pmol/L) and normal FT3 group (FT3 > 3.10pmol/L). All patients were 5-7. All patients were followed up for 6 months to record the mortality during the follow up period. Echocardiography was performed to measure cardiac function in patients with left ventricular ejection fraction (LVEF%).
The results were followed up for 6 months. Kaplan-Meier method was used to assess the mortality between the two groups and whether there was a significant difference in the survival rate between the two groups with Log-rank test. A total of 7 people in the low FT3 group died, and the survival rate was 83.3% lower than that of the normal FT3 group (x2=4.493, P=0.034). The linear regression analysis was positive correlation between FT3 and LVEF% (y=4.92+40.3, P0.001).FT3 and NT-proBNP. There was a negative linear correlation (y=-1905x+8839, P0.001). There was a significant difference in the severity of coronary artery lesions between the two groups by Pearson chi square test (P0.001).
Conclusion by analyzing 102 STEMI patients with direct PCI, this study found that the level of FT3 was associated with the severity of cardiac function after myocardial infarction. The increase of.FT3 in low FT3 STEMI patients could be used as an indicator of prognosis in STEMI patients.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R542.22

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