合并甲状旁腺功能亢进症对急性心肌梗死患者介入治疗后并发主要心血管不良事件的影响

Effect of Combined Hyperparathyroidism on Major Cardiovascular AdverseEvents in Patients with Myocardial Infarction After Interventional Therapy

目的探析合并甲状旁腺功能亢进症(简称甲旁亢)对急性心肌梗死(AMI)患者介入治疗后并发主要心血管不良事件(MACE)的影响。方法选取2019年1月至2021年12月在河南中医药大学第五临床医学院(郑州人民医院)接受经皮冠脉介入(PCI)治疗的142例AMI患者作为研究对象。根据研究目的,于入院时接受相关检查评估患者是否合并甲旁亢,并记录患者一般临床资料,且治疗出院后接受为期1 a的随访,记录1 a内MACE发生情况,分析合并甲旁亢对AMI患者介入治疗后并发MACE的影响。结果本研究共收录AMI介入治疗患者142例,2例患者随访期间失访,1例患者试验过程中依从性较差,1例患者主动要求退出研究,最终138例患者完成试验,其中32例患者发生肌少症,发生率为23.19%。两组性别、年龄、体重指数、基础疾病史、吸烟史、饮酒史、血红蛋白(Hb)、白细胞计数(WBC)、红细胞计数(RBC)、血小板(PLT)、QT间期、Tp-Tec比较,差异无统计学意义(P>0.05);发生组氨基末端脑钠肽前体(NT-proBNP)、肌钙蛋白Ⅰ、血清甲状旁腺激素(PTH)水平和合并甲旁亢占比均高于未发生组(P<0.05)。使用点二列相关性检验,合并甲旁亢与AMI患者介入治疗后并发MACE呈正相关(P<0.05)。构建logistic回归模型,数据显示合并甲旁亢、肌钙蛋白Ⅰ、NT-proBNP和血清PTH均可增加AMI患者介入治疗后并发MACE风险(P<0.05)。结论合并甲旁亢是AMI患者介入治疗后并发MACE的独立影响因素,当AMI患者介入治疗后合并甲旁亢时,患者术后并发MACE的风险明显增加。

Objective To explore the impact of combined hyperparathyroidism(abbreviated as hyperparathyroidism)on major cardiovascular adverse events(MACE)in patients with acute myocardial infarction(AMI)after interventional therapy.Methods A total of 142 AMI patients who underwent percutaneous coronary intervention(PCI)treatment at the Fifth Clinical College of Henan University of Traditional Chinese Medicine(People’s Hospital of Zhengzhou)from January 2019 to December 2021 were selected as the study subjects.According to the research purpose,relevant examinations were conducted on admission to evaluate whether the patient had concomitant hyperparathyroidism,and general clinical information was recorded.After treatment and discharge,a one-year follow-up was conducted to record the occurrence of MACE within one year,and to analyze the impact of concomitant hyperparathyroidism on MACE in AMI patients after interventional treatment.Results This study included a total of 142 patients with AMI intervention treatment,2 patients were lost during follow-up,1 patient had poor compliance during the trial,1 patient voluntarily requested to withdraw from the study,and ultimately 138 patients completed the trial.Among them,32 patients developed sarcopenia,with an incidence rate of approximately 23.19%.There was no statistical significant difference between the two groups in terms of gender,age,body mass index,basic disease history,smoking history,alcohol consumption history,hemoglobin(Hb),white blood cell count(WBC),red blood cell count(RBC),platelet count(PLT),QT interval,and Tp-Tec(P>0.05).The levels of N-temrina pro-barin natriuretic peptide(NT-proBNP),troponinⅠ,serum parathyroid hormone(PTH),and the proportion of concurrent hyperparathyroidism in the occurrence group were higher than those in the non-occurrence group(P<0.05).Point two column correlation test was used,there was a positive correlation between patients with combined hyperparathyroidism and MACE after AMI intervention treatment(P<0.05).A logistic regression model was constructed,the data showed that the combination of hyperparathyroidism,troponinⅠ,NT-proBNP and serum PTH all increased the risk of MACE in patients with AMI after interventional therapy(P<0.05).Conclusion The combination of hyperparathyroidism is an independent influencing factor for MACE in patients with AMI after interventional therapy.When patients with hyperparathyroidism are treated with AMI,the risk of postoperative MACE is significantly increased.