游离三碘甲状腺原氨酸与急性心力衰竭患者近期和远期预后的关系分析  

The relationship between free triiodothyronine level and short-and long-term prognosis of patients with acute heart failure

作　　者：全军民[1] 姚琪[1] 陶袁[1] 邱樑 周林丽[1] 陈浩[1] 俞林[1] 吕峰[1] 曲迪[1] 潘金安 

机构地区：[1]浙江省嵊州市人民医院心内科,312400

出　　处：《心电与循环》2015年第5期329-333,共5页Journal of Electrocardiology and Circulation

摘　　要：目的探讨甲状腺激素水平与急性心力衰竭患者近期和远期预后的关系。方法纳入716例急性心力衰竭患者。入院24h内采集血样测定甲状腺激素、肾功能、电解质、B型脑钠肽。根据游离三碘甲状腺原氨酸（FT3）四分位数（Quartile）水平分为4组（Q1～4组）。应用logistic回归和Cox风险模型分析甲状腺激素与全因死亡的关系。结果在（19±13）个月的随访期间，死亡214例（34.6%）。随着FT3水平下降，患者全因死亡率呈上升趋势。多因素Cox分析显示FT3是30d死亡（HR=0.812，95％CI 0.615～1.009，P＜0.01）和长期全因死亡（HR=0.789，95％CI 0.664～0.937，P＜0.01）的独立风险因子。Kaplan- Meier显示Q1组与Q2～4组比较死亡率差异有统计学意义（P＜0.01）。结论低FT3的急性心力衰竭患者近期和远期死亡率增高。Objective To investigate the relationship between plasma free tri odothyronine （FT3） level and short- and long- term prognosis of patients with acute heart failure （AHF）. Methods A total of 716 AHF patients were enrol ed in this study. Plasma thyroid hormone, renal function, electrolytes and brain natriuretic peptide （BNP） were measured within 24h after admission. The patients were grouped according to quartile of FT3 level. The correlation between thyroid hormone level and al- cause mortality was assessed using logistic regression and Cox hazards model. Results 214 patients （34.6%） died during fol ow- up of 19 ±13 months. The al- cause mortality increased as FT3 level decreased. Multivariate Cox analysis showed FT3 was an independent predictor for both thirty- day mortality （HR=0.812, 95%CI 0.615~1.009, P〈0.01） and long- term al- cause mortality （HR=0.789, 95%CI 0.664~0.937, P〈0.01） .Kaplan- Meier analysis showed significant difference in mortality between 2nd to 4th quartiles and 1st quartile（P〈0.01）. Conclusion AHF patients with low FT3 level may have higher short- and long- term al- cause mortality.

关 键 词：急性心力衰竭 游离三碘甲状腺氨酸 预后 

分 类 号：R541.6[医药卫生—心血管疾病]