促甲状腺激素对冠心病患者行经皮冠状动脉介入术预后的影响

发布时间：2018-12-31 18:41

【摘要】：目的研究正常范围内不同浓度梯度的促甲状腺激素(thyroid-stimulating hormone,TSH)对冠心病患者行经皮冠状动脉介入术(percutaneous coronary interventions,PCI)预后的影响及其临床意义。方法回顾性纳入1 002例行PCI且TSH处于正常范围内(0.30~4.20μIU/m L)的冠心病患者,将受试者分为3组:TSH正常低值组(0.30~1.60μIU/m L,387例)、TSH正常中值组(1.61~2.90μIU/m L,413例)、TSH正常高值组(2.91~4.20μIU/m L,202例),随访时间1年,终点事件是全因死亡,并统计出血事件和再入院事件。结果正常低值组全因死亡事件6例,全因死亡率1.55%;正常中值组全因死亡事件8例,全因死亡率1.94%;正常高值组全因死亡事件10例,全因死亡率4.95%;各组之间比较差异有统计学意义(P0.05)。正常低值组再出血事件13例,再出血率3.36%;正常中值组再出血事件14例,再出血率3.39%;正常高值组再出血事件16例,再出血率7.92%;各组之间比较差异有统计学意义(P0.05)。正常低值组再入院事件38例,再入院率9.82%;正常中值组再入院事件27例,再入院率6.54%;正常高值组再入院事件15例,再入院率7.43%;各组之间比较差异无统计学意义(P0.05)。Logistic回归分析显示正常高值的TSH(OR=1.48)是PCI术后全因死亡的危险因素,同时正常高值的TSH(OR=1.47)是PCI术后出血的危险因素。生存分析也进一步证明正常高值的TSH是PCI术后全因死亡的危险因素(P0.05)。结论 TSH水平越高,全因死亡事件、再出血事件的发生率越高;正常高值的TSH是经皮冠状动脉介入治疗的全因死亡和出血事件的危险因素。
[Abstract]:Objective to study the effect of thyroid stimulating hormone (thyroid-stimulating hormone,TSH) on the prognosis of patients with coronary heart disease (CHD) undergoing percutaneous coronary intervention (percutaneous coronary interventions,PCI) and its clinical significance. Methods 1 002 coronary heart disease patients with PCI and TSH within normal range (0.30 卤4.20 渭 IU/m / L) were retrospectively included. The subjects were divided into 3 groups: TSH normal low value group (0.30 卤1.60 渭 IU/m L, n = 387). The median value of TSH group (1.61 卤2.90 渭 IU/m / L) was 1.61 卤2.90 渭 IU/m / L (2.91 卤4.20 渭 IU/m / L), followed up for 1 year. The end point event was all cause of death, and the bleeding events and readmission events were counted. Results there were 6 cases of death events in the normal low value group, 1.55% of the total death rate, 8 cases of all the death events in the normal median group, 1.94% of the total death rate, 10 cases of all the death events in the normal high value group, and 4.95% of the total death rate. The difference between the groups was statistically significant (P0.05). In the normal low value group, there were 13 cases of rebleeding event, the rate of rebleeding was 3.36%, the mean group of normal value group was 14 cases of rebleeding event, the rate of rebleeding was 3.39 cases, the rebleeding rate of normal high value group was 7.92 2, and that of normal high value group was 7.92%. The difference between the groups was statistically significant (P0.05). In the normal low value group, the readmission rate was 9.82%, the normal median group was 27 cases, the readmission rate was 6.54, the normal high value group was 15 cases, the readmission rate was 7.43; There was no significant difference between the groups (P0.05). Logistic regression analysis showed that the normal high value of TSH (OR=1.48) is the risk factor of death after PCI, and the normal high value of TSH (OR=1.47) is the risk factor of PCI postoperative hemorrhage. Survival analysis further demonstrated that normal high TSH was a risk factor for all death after PCI (P0.05). Conclusion the higher the level of TSH, the higher the incidence of death events and rebleeding events, and the higher the normal value of TSH is the risk factor of death and bleeding events in percutaneous coronary intervention.
【作者单位】：第三军医大学新桥医院心血管内科全军心血管病研究所;
【分类号】：R541.4

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