Gal-3、Hcy和甲状腺功能水平与急性心肌梗死患者心力衰竭程度及预后的相关性  

Correlation of Gal-3,Hcy and thyroid function with the severity and prognosis of heart failure in patients with acute myocardial infarction

作　　者：冯建双 杨红梅[2] 代玉涵 李洋[3] FENG Jian-shuang;YANG Hong-mei;DAI Yu-han(Department of Cardiovascular Medicine,Department of Cardiology,The First Hospital of Qinhuangdao,Qinhuangdao Hebei 066000,China;Intensive Care Unit,Department of Cardiology,The First Hospital of Qinhuangdao,Qinhuangdao Hebei 066000,China)

机构地区：[1]秦皇岛市第一医院心血管内科,河北秦皇岛066000 [2]秦皇岛市第一医院心内科重症监护室,河北秦皇岛066000 [3]秦皇岛市第一医院导管室,河北秦皇岛066000

出　　处：《临床和实验医学杂志》2024年第11期1134-1138,共5页Journal of Clinical and Experimental Medicine

基　　金：河北省医学科学研究项目(编号:20211344);秦皇岛市科学技术研究与发展计划(编号:202004A126)。

摘　　要：目的 探究血清半乳凝素-3(Gal-3)、同型半胱氨酸(Hcy)和甲状腺功能水平与急性心肌梗死患者心力衰竭程度及预后的相关性。方法 回顾性选取2018年4月至2020年4月在秦皇岛市第一医院接受治疗的100例急性心肌梗死患者,根据患者是否发生心力衰竭将患者分组:56例患者未发生心力衰竭,纳入对照组,其他44例发生心力衰竭的患者纳入观察组。比较2组患者的血清Gal-3、Hcy和游离三碘甲腺原氨酸(FT_(3))、游离甲状腺素(FT_(4))、促甲状腺激素(TSH)水平;根据Killip分级将观察组患者分为轻度组(n=16)、中度组(n=19)、重度组(n=9),比较3组患者的Gal-3、Hcy、FT_(3)、FT_(4)、TSH水平;对观察组患者进行1年随访,根据患者随访期内是否发生主要心血管不良事件(MACE)将患者分为预后良好组(n=28)和预后不良组(n=16),比较2组患者的Gal-3、Hcy、FT_(3)、FT_(4)、TSH水平。采用受试者操作特征(ROC)曲线分析Gal-3、Hcy、FT_(3)、FT_(4)、TSH水平对患者预后的预测价值。结果 观察组患者的Gal-3、Hcy、TSH水平分别为(13.33±3.87)μg/L、(19.11±3.16)μmol/L、(8.49±2.46) mIU/L,均高于对照组[(9.98±3.12)μg/L、(16.56±3.05)μmol/L、(6.45±2.04) mIU/L],FT_(3)、FT_(4)水平分别为(1.25±0.56)、(6.45±1.78) pmol/L,均低于对照组[(1.55±0.31)、(7.56±1.25) pmol/L],差异均有统计学意义(P<0.05)。不同程度心力衰竭患者组间Gal-3、Hcy、FT_(3)、FT_(4)、TSH水平比较,差异均有统计学意义(P<0.05),随着病情严重程度越重,Gal-3、Hcy、TSH水平越高,FT_(3)、FT_(4)水平越低。预后不良组患者的Gal-3、Hcy、TSH水平均高于预后良好组,FT_(3)、FT_(4)水平均低于预后良好组,差异均有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,患者血清Gal-3、Hcy、FT_(3)、FT_(4)、TSH水平均是患者预后的影响因素(P<0.05)。Gal-3、Hcy、FT_(3)、FT_(4)、TSH水平预测患者预后不良的曲线下面积分别为0.985、0.877、0.Objective To explore the correlation between serum galectin-3(Gal-3),homocysteine(Hcy)and thyroid function levels and the severity and prognosis of heart failure in patients with acute myocardial infarction.Methods A total of 100 patients with acute myocardial infarction who received treatment in the First Hospital of Qinhuangdao from April 2018 to April 2020 were selected and grouped according to whether they developed heart failure:56 patients without heart failure were included in the control group,and the other 44 patients with heart failure were included in the observation group.The levels of serum Gal-3,Hcy and free triiodothyronine(FT_(3)),free thyroxine(FT_(4)),thyroid stimulating hormone(TSH)in the two groups were compared.According to the Killip classification,the observation group were divided into the mild group(n=16),moderate group(n=19),and severe group(n=9),the levels of Gal-3,Hcy,FT_(3),FT_(4),and TSH among the three group were compared.Patients in the observation group were followed up for one year,and divide them into the good prognosis group(n=28)and the poor prognosis group(n=16)based on whether major cardiovascular adverse events(MACE)occurred during the follow-up period,the levels of Gal-3,Hcy,FT_(3),FT_(4),and TSH between the two groups were compared.The predictive value of Gal-3,Hcy,FT_(3),FT_(4),and TSH levels on patient prognosis were analyzed using receiver operating characteristic(ROC)curves.Results The levels of Gal-3,Hcy,and TSH in the observation group were(13.33±3.87)μg/L,(19.11±3.16)μmol/L,(8.49±2.46)mIU/L,respectively,which were higher than those in the control group[(9.98±3.12)]μg/L,(16.56±3.05)μmol/L,(6.45±2.04)mIU/L,the levels of FT_(3) and FT_(4) in the observation group were(1.25±0.56),and(6.45±1.78)pmol/L,respectively,which were lower than those in the control group[(1.55±0.31),(7.56±1.25)pmol/L],the differences were statistically significant(P<0.05).The levels of Gal-3,Hcy,FT_(3),FT_(4),and TSH were compared between groups of patients with different degrees o

关 键 词：急性心肌梗死 心力衰竭 预后 半乳凝素-3 同型半胱氨酸 甲状腺功能 相关性 

分 类 号：R542.22[医药卫生—心血管疾病] R541.6[医药卫生—内科学]