血儿茶酚胺甲状腺激素对STEMI患者心功能的影响  

作　　者：沈剑耀 王黎 任品芳 

机构地区：[1]绍兴文理学院附属中心医院,312030

出　　处：《浙江临床医学》2020年第9期1280-1281,共2页Zhejiang Clinical Medical Journal

基　　金：浙江省绍兴市柯桥区科技攻关计划项目(2016KZ060)。

摘　　要：目的探讨急性ST段抬高心肌梗死(STEMI)急诊再灌注患者血清甲状腺激素、儿茶酚胺水平对心功能的影响.方法选择2017年12月至2018年12月STEMI行急诊经皮冠状动脉介入治疗(PCI)的患者,采集甲状腺功能、儿茶酚胺、proBNP及心肌酶、肌钙蛋白、心脏射血分数等指标,根据患者心功能情况分为心衰组(26例)及非心衰组(37例),比较两组间各项指标的差异.结果两组患者PCI成功率均为100%.与非心衰组相比,心衰组术前血FT3、去甲肾上腺素(NE)、肌酸激酶同工酶(CKMB)、脑钠肽前体(proBNP)、左室舒张末期内径(LVDD)、左室射血分数(EF值)差异有统计学意义(P<0.05).两组患者血肾上腺素(E)、FT3、FT4、TSH及肌钙蛋白差异无统计学意义(P>0.05).Cox回归分析显示,FT3、NE水平可作为心衰发生的独立危险因素.结论STEMI急诊再灌注治疗患者即刻血FT3、NE水平可预测心衰发生发展,一定程度上可以预测患者短期预后情况.Objective To investigate the efect of serum thyroid hormone and catecholamine levels on cardiac function in patients with acute ST-segment elevation myocardial infarction.Method Between December 2017 and December 2018,a total of 63 patients presented with STEMI and underwent emergency PCI were enrolled in this study.Thyroid function,catecholamine,proBNP,myocardial enzymes,troponin and left ventricle ejection fraction were collected for all the enrolled patients.According to the patients’cardiac function,they were divided into two groups.One was heart filure group(26 cases)and another was non--heart filure group(37 cases).The diferences of each index berween the two groups were compared and estimated.Results Among 63 patients,all PCI surgery was sccessful in both groups.Compared with non-heart failure group.there were signifcant dfferences in serum FT3,Norepinephrine(NE),CKMB,proBNP,LVDD and EF value(P<0.05).There were no significant differences in serum Epinephrine(E),FT3(at other time points),FT4,TSH and troponin between two groups(P>0.05).Cox regression analysis showed that FT3 and NE levels could be the influencing factors of heart failure.Conclusions Serum FT3 and NE levels in patients with acute ST-segment elevation myocardial infarction undergoing emergency reperfusion therapy can predict the occurrence and development of heart failure and short-term prognosis to some extent.

关 键 词：心肌梗死 甲状腺激素 儿茶酚胺 

分 类 号：R54[医药卫生—心血管疾病]