正常甲状腺病态综合征与急性ST段抬高型心肌梗死患者梗死面积及预后的相关性分析  

Clinical Study on Infarct Size and Prognosis of Patients with ST-segment Elevation Myocardial Infarction and Euthyroid Sick Syndrome

作　　者：王琳琳 梁翠格 冀庆荣 刘世霞 赵琪 Wang Linlin;Liang Cuige;Ji Qingrong;Liu Shixia;Zhao Qi(Postgraduate Training Base of Jinzhou Medical University,Linyi People′s Hospital,Jinzhou 121000 China)

机构地区：[1]锦州医科大学临沂市人民医院研究生培养基地,辽宁锦州121000

出　　处：《锦州医科大学学报》2023年第6期66-71,76,共7页Journal of Jinzhou Medical University

基　　金：山东省医药卫生科技发展计划项目,项目编号:202003011154。

摘　　要：目的探讨正常甲状腺病态综合征(euthyroid sick syndrome,ESS)与急性ST段抬高型心肌梗死(ST-segment elevation myocardial infarction,STEMI)患者心肌梗死面积和预后的关系。方法随机选取454例STEMI患者为研究对象,分为正常甲状腺功能(euthyroid,EU)组(n=351)和ESS组(n=103)。采用Selvester QRS评分系统计算心肌梗死面积,利用秩相关分析明确ESS与STEMI患者心肌梗死面积的关系。绘制Kaplan-Meier生存曲线,通过COX回归分析STEMI患者中ESS与预后的关系。结果两组患者心肌梗死面积比较,差异有统计学意义(P<0.05),且FT3与心肌梗死面积呈明显负相关(r=-0.174,P<0.01),经多因素COX回归分析,低FT3会增加患者复合终点事件发生率(P=0.012,OR=0.323,95%CI:0.134~0.774),FT3水平是影响患者预后的独立预测因子。结论ESS与STEMI患者心肌梗死面积和不良预后密切相关,其中FT3水平是影响STEMI患者预后的独立预测因子。Objective To analyze the correlation between ESS and MI size and prognosis in patients with STEMI.Methods A total of 454 STEMI patients were randomly divided into euthyroid(EU)group(n=351)and ESS group(n=103).Selvester QRS scoring system was used to calculate MI size,and rank correlation analysis was used to determine the relationship between ESS and MI size of STEMI.Kaplan-Meier survival curve was drawn,and the relationship between ESS and prognosis of STEMI was analyzed by COX regression.Results There was a statistically significant difference in MI size between the two groups(P<0.05),and FT3 was significantly negatively correlated with MI size(r=-0.174,P<0.01).Multivariate COX regression analysis showed that low FT3 would increase the incidence of complex endpoint events in patients(P=0.012,OR=0.323,95%CI:0.134~0.774),FT3 level was an independent predictor of prognosis.Conclusion ESS is closely associated with MI size and poor prognosis of STEMI,and FT3 level is an independent predictor of prognosis in STEMI patients.

关 键 词：正常甲状腺病态综合征 急性ST段抬高型心肌梗死 心肌梗死面积 预后 

分 类 号：R542.22[医药卫生—心血管疾病]