急性心肌梗死合并非甲状腺病态综合征的相关研究

Related study on acute myocardial infarction complicated with non-thyroidal illness syndrome

目的探讨急性心肌梗死(AMI)患者合并非甲状腺病态综合征(NTIS)时FT_3水平对患者远期死亡率的影响。方法共纳入1 809例AMI患者,按甲状腺功能检查分为NTIS组和甲功正常组,随访1~8.5年,采用多因素COX回归分析方法,研究FT_3水平对AMI患者远期全因死亡、心血管死亡的影响。结果 AMI患者中NTIS的发生率为21.7%。与甲功正常组相比,NTIS组住院死亡率、远期全因死亡率和远期心血管死亡率均升高(14.3%vs.1.8%,23.1%vs.14.5%,14.0%vs.7.6%,P<0.05)。FT_3水平(HR=0.304,95%CI:0.134~0.693,P=0.005)与AMI患者远期全因死亡的独立相关,FT_3水平(HR=0.241,95%CI:0.093~0.622,P=0.003)也是AMI患者远期心血管死亡的独立危险因素。结论 AMI患者中常见NTIS,FT_3水平是AMI患者远期全因死亡和心血管死亡的独立危险因素。

ObjectiveTo investigate the effect of FT3 on the long term mortality of patients with acute myocardial infarction（AMI） complicated with non thyroidal illness syndrome （NTIS）. MethodsA total of 1 809 patients with AMI were divided into NTIS group and normal group. The patients were followed up for 1 to 8.5 years. The multivariate COX regression analysis was used to study the effect of FT3 on long term all cause mortality and cardiovascular mortality in AMI patients. ResultsThe incidence rate of NTIS in AMI patients was 21.7%. Compared with the normal control group, the in hospital mortality, long term all cause mortality and long term cardiovascular mortality in the NTIS group were significantly higher （14.3% versus 1.8%, 23.1% versus 14.5%, 14% versus 7.6%, P〈 0.05）. The level of FT3 （HR=0.304, 95%CI： 0.134~0.693, P=0.005） was correlated with long term all cause mortality in patients with AMI, and FT3 level （HR=0.241, 95%CI： 0.093-0.622, P=0.003） is an independent risk factor for long term cardiovascular death in patients with AMI. ConclusionNTIS exists in AMI commonly. FT3 level is an independent risk factor for long term all cause death and cardiovascular death in patients with AMI.