本文選題：急性心肌梗死 + 甲狀腺激素　； 參考：《青島大學(xué)》2014年碩士論文

【摘要】：目的分析接受直接經(jīng)皮冠脈介入治療(primary percutaneous coronary intervention, PCI)的急性ST段抬高型心肌梗死(ST-elevation myocardial infarction,STEMI)患者甲狀腺激素水平對(duì)其近期預(yù)后評(píng)價(jià)的價(jià)值。 方法連續(xù)入選甲狀腺功能正常的行直接PCI的STEMI患者102例。于直接PCI后24小時(shí)內(nèi)采集外周靜脈血,測(cè)游離三碘甲狀腺原氨酸(FT3),N末端腦鈉肽前體(NT-proBNP)。根據(jù)FT3水平分為低FT3組(FT33.10pmol/L)和正常FT3組(FT3≥3.10pmol/L)。所有患者于發(fā)病5-7天內(nèi)行心臟超聲檢查,測(cè)左室射血分?jǐn)?shù)(LVEF%)反應(yīng)患者心功能情況。所有患者隨訪6個(gè)月,記錄隨訪期間的死亡情況。 結(jié)果隨訪6個(gè)月,用Kaplan-Meier法評(píng)估兩組之間死亡率并用Log-rank檢驗(yàn)兩組生存率差異是否有統(tǒng)計(jì)學(xué)意義,低FT3組共7人死亡、生存率為83.3%低于正常FT3組的96.5%(x2=4.493,P=0.034)。用線性回歸分析FT3與LVEF%呈正相關(guān)(y=4.92+40.3, P0.001)。FT3與NT-proBNP呈負(fù)線性相關(guān)(y=-1905x+8839, P0.001)。用Pearson卡方檢驗(yàn)比較兩組患者的冠脈病變程度有顯著性差異(P0.001)。 結(jié)論本研究通過(guò)分析102名行直接PCI的STEMI患者,發(fā)現(xiàn)FT3水平與心肌梗死后心功能嚴(yán)重程度相關(guān),低FT3的STEMI患者死亡率升高。FT3可以作為評(píng)價(jià)STEMI患者預(yù)后的指標(biāo)。
[Abstract]:Objective to evaluate the value of thyroid hormone levels in patients with acute ST segment elevation myocardial infarction (ST-elevation myocardial infarction, STEMI) with primary percutaneous coronary intervention (PCI) for short-term prognosis evaluation.
Methods 102 cases of STEMI patients with normal thyroid function were selected for direct PCI. Peripheral venous blood was collected within 24 hours after direct PCI. Free three iodine thyroprosine (FT3) and N terminal brain natriuretic precursor (NT-proBNP) were measured. According to the FT3 level, there were low FT3 group (FT33.10pmol/L) and normal FT3 group (FT3 > 3.10pmol/L). All patients were 5-7. All patients were followed up for 6 months to record the mortality during the follow up period. Echocardiography was performed to measure cardiac function in patients with left ventricular ejection fraction (LVEF%).
The results were followed up for 6 months. Kaplan-Meier method was used to assess the mortality between the two groups and whether there was a significant difference in the survival rate between the two groups with Log-rank test. A total of 7 people in the low FT3 group died, and the survival rate was 83.3% lower than that of the normal FT3 group (x2=4.493, P=0.034). The linear regression analysis was positive correlation between FT3 and LVEF% (y=4.92+40.3, P0.001).FT3 and NT-proBNP. There was a negative linear correlation (y=-1905x+8839, P0.001). There was a significant difference in the severity of coronary artery lesions between the two groups by Pearson chi square test (P0.001).
Conclusion by analyzing 102 STEMI patients with direct PCI, this study found that the level of FT3 was associated with the severity of cardiac function after myocardial infarction. The increase of.FT3 in low FT3 STEMI patients could be used as an indicator of prognosis in STEMI patients.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R542.22

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