甲状腺激素水平与急性心肌梗死患者介入治疗术后不良心血管事件发生的相关性

Correlation between thyroid hormone level and adverse cardiovascular events after interventional therapy in patients with acute myocardial infarction

目的分析甲状腺激素水平与急性心肌梗死(AMI)患者经皮冠状动脉介入治疗(PCI)术后不良心血管事件发生的相关性。方法抽取2018年10月至2020年10月郑州颐和医院收治的AMI患者300例,所有患者均接受PCI治疗,于确诊时检测甲状腺激素[游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)及促甲状腺激素(TSH)]水平,均随访1年,并根据随访期间不良心血管事件发生情况将纳入患者分为发生组和未发生组。搜集患者基线资料,纳入可能的影响因素,分析甲状腺激素水平对AMI患者PCI后并发不良心血管事件的影响。结果300例AMI患者PCI后经1年随访,35例患者发生不良心血管事件,发生率为11.67%(35/300),纳入发生组;其余265例患者纳入未发生组。发生组患者确诊时TSH水平高于未发生组,FT3水平低于未发生组(P<0.05);两组其他基线资料比较差异未见统计学意义(P>0.05)。Logistic回归分析结果显示,TSH水平过表达是AMI患者PCI后并发不良心血管事件的危险因素(OR>1,P<0.05),FT3水平过表达是AMI患者PCI后并发不良心血管事件的保护因素(OR<1,P<0.05)。结论甲状腺激素中TSH、FT3水平对AMI患者PCI后并发不良心血管事件具有一定影响,且TSH水平过表达、FT3水平低表达提示AMI患者PCI后不良心血管事件发生风险较高。

Objective To analyze the correlation between thyroid hormone level and adverse cardiovascular events after percutaneous coronary intervention(PCI)in patients with acute myocardial infarction(AMI).Methods A total of 300 patients with AMI treated in the Zhengzhou Yihe Hospital from October 2018 to October 2020 were selected.All patients were treated by PCI.The levels of thyroid hormones including free triiodothyronine(FT3),free thyroxine(FT4)and thyroid stimulating hormone(TSH)were measured at the time of definite diagnosis.All the patients were followed up for 1 year,and the patients were divided into occurrence group and non occurrence group according to the occurrence of adverse cardiovascular events during the follow-up period.The baseline information of the patients were collected,and the possible influencing factors were included.The effect of thyroid hormone level on adverse cardiovascular events in patients with AMI after PCI was analyzed.Results All the 300 patients with AMI were followed up for one year after PCI,of which 35 patients had adverse cardiovascular events,with an incidence of 11.67%(35/300),and they were included into the occurrence group;the remaining 265 patients were included in the non occurrence group.The level of TSH in the occurrence group was higher than that in the non occurrence group,and the level of FT3 was lower than that in the non occurrence group at the time of definite diagnosis(P<0.05).There was no statistical significant difference in other baseline data between the two groups(P>0.05).The results of Logistic regression analysis showed that TSH overexpression was a risk factor for adverse cardiovascular events after PCI in patients with AMI(OR>1,P<0.05),and overexpression of FT3 was a protective factor for adverse cardiovascular events after PCI in patients with AMI(OR<1,P<0.05).Conclusions The levels of thyroid hormone(TSH and FT3)have certain effect on adverse cardiovascular events in patients with AMI after PCI.The overexpression of TSH and low expression of FT3 suggest that AMI patients have a higher risk of adverse cardiovascular events after PCI.