摘要
目的 :研究亚临床甲状腺功能减退(简称:亚临床甲减)与冠状动脉旁路移植术(CABG)患者术后治疗的相关性。方法 :收集2010-07至2014-03我院同一手术团队1 500例单纯行CABG患者资料,其中亚临床甲减组107例,甲状腺功能正常组1 393例,经1:4比例倾向性评分匹配后,共104对行CABG患者最终纳入研究。观察项目包括:主动脉内球囊反搏(IABP)置入率、围术期的输血率、机械呼吸辅助时间、新发脑梗死、新发心肌梗死、新发心房颤动、恶性心律失常、急性肾功能不全、院内死亡等事件。本研究比较了经倾向性匹配后的两组术后事件,并对治疗结果进行单因素和多因素分析。结果:经倾向性匹配后,亚临床甲减组的机械辅助呼吸时间明显长于甲状腺功能正常组(23.3±47.9 vs 15.0±5.5,P〈0.05),机械辅助呼吸时间〉12 h率高于甲状腺功能正常组(89.4%vs 78.8%,P〈0.05),IABP置入高于甲状腺功能正常组(3.8%vs 0.72%,P〈0.05),且与亚临床甲减存在相关性[比值比(OR)值分别为2.363及6.126,95%可信区间(95%CI)分别为1.183~4.516及1.190~31.537)。包括院内死亡等其他事件两组差异无统计学意义(P〉0.05)。结论:基于本研究两组资料,亚临床甲减组与机械辅助呼吸时间及IABP置入比率存在相关性。
Objective: To study subclinical hypothyroidism (SCH) with its treatment in patients after coronary artery bypass grafting (CABG). Methods: A total of 1500 patients received CABG by the same surgical team in our hospital from 2010-06 to 2014-03 were retrospectively studied. According to thyroid function, the patients were divided into 2 groups: SCH group,n=107 and Normal group, n=1393. With 1:4 propensity score matching, there were 104 patients in SCH group and 416 patients in Normal group enrolled in our research. The rates of intra-aortic balloom pumping (IABP) implantation and peri-operational blood transfusion, mechanical ventilation time, new onsets of stroke, myocardial infarction and atrial ifbrillation, malignant arrhythmia, acute kidney injury and in-hospital mortality were observed. The outcome of treatment was assessed by single- and multi-factor analysis. Results: Compared with Normal group, SCH group showed increased mechanical ventilation time (23.3±47.9) h vs (15.0±5.5) h, P〈0.05; more patients had mechanical ventilation time〉12 h (89.4% vs 78.8%),P〈0.05 and more patients had IABP implantation (3.8% vs 0.72%),P〈0.05. SCH was related to mechanical ventilation time〉12 h (OR=2.363, 95% CI 1.183-4.516) and IABP implantation (OR=6.126, 95% CI 1.190-31.537). The in-hospital death and other events were similar between 2 groups,P〉0.05. Conclusion: Our research indicated that SCH was related to mechanical ventilation time and IABP implantation in patients after CABG.
作者
王恒
李立环
姚允泰
周程辉
方能新
陈东
WANG Heng LI Li-huan YAO Yun-tai ZHOU Cheng-hui FANG Neng-xin CHEN Dong(Department of Anesthesiology, Cardiovascular Institute and Fu Wai Hospital, CAMS and PUMC, Beijing (100037), China)
出处
《中国循环杂志》
CSCD
北大核心
2016年第9期870-873,共4页
Chinese Circulation Journal