游离三碘甲状腺原氨酸对急性心肌梗死PCI术后心功能及近期死亡率的评价  

Evaluation of heart function and short - term mortality by free - triiodothyronine in acute myocardial infarction patients undergoing primary percutaneous coronary intervention therapy

作　　者：张虎[1] 周长勇[2] 王旖旎[2] 王淑娟[2] 秦桥基[2] 黄欢[2] 

机构地区：[1]青岛大学医学院,山东青岛266021 [2]青岛大学附属医院急诊内科,山东青岛266003

出　　处：《中国急救医学》2014年第5期419-422,共4页Chinese Journal of Critical Care Medicine

基　　金：青岛市科技发展指导计划项目（KZD-12）

摘　　要：目的分析接受直接经皮冠状动脉介入治疗（PCI）的急性ST段抬高型心肌梗死（STEMI）患者游离三碘甲状腺原氨酸（FT3）对其心功能及其近期死亡率的评价。方法连续入选甲状腺功能正常的行直接PCI的STEMI患者102例，术后24h内采集外周静脉血测FB，根据FT3水平分为低FT3组（FT3～3．10pmol／L）和正常FT3组（FT3≥3．10pmol／L）。所有患者于发病5～7d内行心脏超声检查，测左室射血分数（LVEF）反映患者心功能情况。随访6个月比较两组的生存率。结果STEMI患者FT3与LVEF呈线性正相关（P〈0．001）。随访6个月，低FT3组共7例死亡，生存率为83．3％，低于正常FT3组的96．5％（X^2=4．493，P=0．034）。结论直接PCI的STEMI患者FT3水平与急性心肌梗死（AMI）后心功能严重程度相关，且低FT3的STEMI患者死亡率升高。Objective To investigate the significance of free -triiodothyronine （FT3 ） in evaluating the heart function and short - term mortality in acute myocardial infarction （AMI） patients who received primary percutaneous coronary intervention （PCI）. Methods 102 consecutive euthyroid STEMI patients receiving primary PCI were enrolled in this study. The blood was collected 24 - hour after primary PCI for determination of FT3 level. Echocardiogram was examined between days 5 and days 7 after primary PCI. All patients underwent a follow - up for 6 months for mortality. Results Positive correlation between FT3 and LVEF% was found （P 〈0. 001 ）. There were 7 deaths in low FT3 group, and the survival rate of FT3 group and normal group was 84.4% and 96.5% , respectively （X2 =4. 493, P = 0. 034 ）. Conclusion In STEMI patients after primary PCI, FT3 level is related to the heart function, and low FT3 is a predictor of mortality in STEMI patients.

关 键 词：急性心肌梗死(AMI) 甲状腺激素 经皮冠状动脉介入治疗(PCI) 预后 

分 类 号：R446.112[医药卫生—诊断学]