三碘甲状腺原氨酸对急性ST段抬高心肌梗死急诊PCI治疗后ST段回落和临床预后的影响  

Triiodothyronine associated with ST-segment resolution and clinical outcome in patients with ST segment elevated myocardial infarction underwent primary PCI

作　　者：高瞻[1] 郑高暑[1] 计光[1] 胡开宇[1] 李晟[1] 王智挺 陈长曦[1] 黄伟剑[1] 

机构地区：[1]温州医科大学附属第一医院心血管内科,325000

出　　处：《心电与循环》2015年第5期325-328,337,共5页Journal of Electrocardiology and Circulation

摘　　要：目的探讨三碘甲状腺原氨酸(T3)与急性ST段抬高心肌梗死(STEMI)急诊经皮冠状动脉介入(PCI)治疗后ST段回落和临床预后的关系。方法回顾性分析2012年至2013年期间连续收治的因STEMI在我院行急诊PCI患者205例。采用多变量logistic回归分析血浆T3与急诊PCI术后ST段回落指数(STRI)以及住院期间心血管事件之间的关系。结果血浆低T3是急诊PCI术后ST段不完全回落和住院期间急性左心衰竭发作的独立危险因素。与PCI术后ST段不完全回落的相关的因素还包括肌钙蛋白Ⅰ、左心室射血分数、PCI术后TIMI血流分级。与急性左心衰竭相关的因素还包括肾功能不全、B型脑钠肽(BNP)升高、ST段不完全回落。结论 STEMI患者中血浆T3水平下降,与PCI术后ST段不完全回落相关,预示住院期间发作急性左心衰竭。Objective To investigate the association of tri odothyronine （T3） with ST- segment resolution （STR） and clinical outcome in patients with ST segment elevated myocardial infarction （STEMI） underwent percutaneous coronary intervention （PCI）. Methods Data of 205 consecutive patients with STEMI underwent primary PCI were retrospectively analyzed. Multiple logistic regression analysis was used to determine the relationship between serum T3 level and STR index and in- hospital cardiovascular events. Results Low T3 was an independent predictor of incomplete STR post PCI and in- hospital acute heart failure attack. Other risk factors for incomplete STR included troponin I, left ventricular ejection fraction and TIMI grade post PCI. Renal failure, elevated brain natriuretic peptide and incomplete STR were risk factors for in- hospital heart failure. Conclusion Low T3 is associated with incomplete STR after primary PCI as wel as in- hospital acute heart failure in patients with STEMI.

关 键 词：三碘甲状腺原氨酸 急性ST段抬高心肌梗死 心力衰竭 

分 类 号：R542.22[医药卫生—心血管疾病]