急性冠脉综合征患者PCI术前血清促甲状腺激素水平与术后1年主要心脏不良事件发生的关系  

Relationship between serum thyroid-stimulating hormone level before PCI and one-year major adverse cardiac events after PCI in patients with acute coronary syndrome

作　　者：梁登攀[1] 胡军[1] 王沛坚[1] 王秋林[1] 蔡国才[1] 杨震[1] 李文章[1] 周鹏[1] LIANG Dengpan;HU Jun;WANG Peijian;WANG Qiulin;CAI Guocai;YANG Zhen;LI Wenzhang;ZHOU Peng(The First Affiliated Hospital of Chengdu Medical College,Chengdu 610500,China)

机构地区：[1]成都医学院第一附属医院,成都610500

出　　处：《山东医药》2018年第22期12-15,共4页Shandong Medical Journal

基　　金：四川省医学科研青年创新项目(Q16018);四川省教育厅课题项目(17B0126)

摘　　要：目的探讨急性冠脉综合征患者PCI术前血清促甲状腺激素(TSH)水平与术后1年主要心脏不良事件(MACE)发生的关系。方法收集2014年1月~2015年1月在成都医学院第一附属医院心血管内科住院接受PCI治疗的急性冠脉综合征患者的临床资料,记录患者术前的血清总三碘甲状腺原氨酸(TT3)、总甲状腺素(TT4)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、TSH及生化指标。随访1年,观察纳入研究者的MACE(包括全因死亡、再次心肌梗死、非计划内的心脏血运重建或再次靶血管血运重建)发生情况。分析术前血清TSH水平与术后1年MACE发生的关系。结果共纳入183例急性冠脉综合征患者,10例发生MACE,包括全因死亡事件4例和非计划内的心脏血运重建或再次靶血管血运重建6例。MACE者术前血清TSH水平较非MACE者高(P<0.05)。logistic回归分析发现,PCI术前血清TSH水平是急性冠脉综合征患者术后1年发生MACE的影响因素(OR=1.377,95%CI:1.084~1.749,P<0.05)。结论 PCI术前高血清TSH水平是急性冠脉综合征患者术后1年发生MACE的危险因素。Objective To investigate the relationship between serum thyroid-stimulating hormone(TSH)level before PCI and one-year major adverse cardiac events(MACE)after percutaneous coronary intervention(PCI)in patients with acute coronary syndrome(ACS).Methods From Jan.2014 to Jan.2015,patients from The First Affiliated Hospital of Chengdu Medical College,with ACS and undergoing PCI,were enrolled in this study.The clinical data,serum total triiodothyronine(TT3),total thyroxine(TT4),free triiodothyronine(FT3),free thyroxine(FT4),and thyroid stimulating hormone(TSH)were measured before PCI.All the patients were followed up for one year,and then the incidence of MACE(including all-cause mortality,nonfatal myocardial infarction,unplanned cardiac revascularization or targeted lesion revascularization)was observed,and the relationship between serum TSH level before PCI and the occurrence of MACE was analyzed.Results A total of 183 patients were included,10 with MACE,including 4 with all-cause mortality and 6 with unplanned cardiac revascularization or targeted lesion revascularization.The serum TSH level of the MACE group was significantly higher than that of the non-MACE group(P<0.05).Logistic regression analysis revealed that serum TSH level before PCI was the risk factor for one-year MACE after PCI in patients with ACS(OR=1.377,95%CI:1.084-1.749,P<0.05).Conclusion High serum TSH level before PCI is an independence risk factor for one-year MACE after PCI in patients with ACS.

关 键 词：促甲状腺激素 急性冠脉综合征 经皮冠状动脉介入治疗 主要心脏不良事件 

分 类 号：R541.4[医药卫生—心血管疾病]