甲状腺功能正常的急性冠状动脉综合征冠状动脉重度狭窄患者发生急性心肌梗死的影响因素

An analysis of influencing factors for acute myocardial infarction in patients with acute coronary syndrome with severe coronary artery stenosis and normal thyroid function

目的分析甲状腺功能正常的急性冠状动脉综合征(ACS)冠状动脉(冠脉)重度狭窄患者发生急性心肌梗死的影响因素。方法收集630例冠脉重度狭窄、甲状腺功能指标正常的ACS患者,分为急性心肌梗死组(254例)和不稳定心绞痛组(376例)。收集并比较两组相关临床资料、生化指标和甲状腺功能指标,分析临床相关指标与ACS冠脉重度狭窄患者发生急性心肌梗死的相关性,采用logistic回归分析ACS冠脉重度狭窄患者发生急性心肌梗死的影响因素。结果急性心肌梗死组高脂血症患者比例以及TC、LDL-C、FBG、CRP和FT_(4)水平高于不稳定心绞痛组,TSH水平低于不稳定心绞痛组(P<0.05或P<0.01)。高水平LDL-C、CRP、FT_(4)是甲状腺功能正常的ACS冠脉重度狭窄患者发生急性心肌梗死的独立危险因素(P<0.01),高水平TSH是其保护性因素(P<0.01)。结论对于甲状腺功能正常的ACS冠脉重度狭窄患者,高水平LDL-C、CRP、FT_(4)患者更容易发生急性心肌梗死,而高水平TSH是其保护性因素。

Objective To analyze the influencing factors for acute myocardial infarction in the patients with acute coronary syndrome(ACS)with severe coronary artery stenosis and normal thyroid function.Methods A total of 630 ACS patients with severe coronary artery stenosis and normal thyroid function were divided into two groups of A(with acute myocardial infarction,254 cases)and B(with unstable angina pectoris,376 cases).The clinical data including biochemical indexes and thyroid function indexes were collected and compared between the two groups.The correlation between relavant indexes and acute myocardial infarction in ACS patients with severe coronary artery stenosis was analyzed.The influencing factors for acute myocardial infarction in ACS patients with severe coronary artery stenosis were analyzed with logistic regression analysis.Results The proportion of the patients with hyperlipidemia and the levels of TC,LDL-C,FBG,CRP and FT_(4)were higher,and the level of TSH was lower in group A than those in group B(P<0.05 or P<0.01).High levels of LDL-C,CRP and FT_(4)were the independent risk factors for acute myocardial infarction in ACS patients with severe coronary artery stenosis(P<0.01),and high level of TSH was the protective factor(P<0.01).Conclusion For ACS patients with severe coronary stenosis and normal thyroid function,the patients with high levels of CRP,LDL-C and FT_(4)are more likely to develop acute myocardial infarction,while high level of TSH is the protective factor.