合并低T3综合征对急性前壁心肌梗死患者远期预后的影响

Long term prognostic effect of low T3 syndrome in patients with acute anterior myocardial infarction

关键词:  低T3综合征  急性心肌梗死  血清游离三碘甲状腺原氨酸

Key words:  [Key words] low T3 syndrome  acute myocardial infarction  serum free triiodothyronine

摘要:

[摘要] 目的　观察低T3综合征（LT3S）在急性前壁心肌梗死患者中的发病情况，探讨其对患者远期预后的影响。方法　对住院治疗的急性前壁心肌梗死121例患者行甲状腺功能检测和心脏超声等检查，并根据甲状腺功能情况进行分组；统计随诊期间不良事件发生率（包括再梗、心力衰竭、恶性心律失常及心源性死亡），分析相关影响因素。结果　121例急性前壁心肌梗死患者中51例(42.15%)伴低T3综合征。血清游离三碘甲状腺原氨酸(FT3)水平是远期预后的独立危险因素；低FT3与死亡率明显相关。出院患者平均随访（20.5±7.8）月，Cox模型分析显示，FT3水平是累积死亡风险首要预测因子(HR 5．17，95%CI：2.57～8.69)，其次是年龄和左室射血分数。结论　急性前壁心肌梗死合并低T3综合征对预测患者病情严重程度和远期预后有重要价值。

Abstract:

[Abstract] Objective To observe the prevalence of low T3 syndrome (LT3S) in patients with acute anterior myocardial infarction and study its impact on the long-term prognosis. Methods Totally 121 patients with acute anterior myocardial infarction received thyroid function tests and cardiac ultrasound examination. They were grouped according to the thyroid hormone profile. Statistical analysis of adverse outcomes during follow-up (including re-infarction, heart failure, malignant arrhythmias and cardiac death) were performed to correlate with the related factors. Results Among the 121 patients with acute anterior myocardial infarction, 51 cases (42.15%) had low T3 syndrome. Free triiodothyronine (FT3) level was an independent risk factor for long-term prognosis; low FT3 was significantly associated with mortality. The average time of patients discharged from hospital during follow-up was (20.5±7.8) months. Cox regression analysis showed that FT3 level was the primary predictor of the cumulative risk of death (HR 5.17, 95% CI:2.57-8.69), followed by age and left ventricular ejection fraction. Conclusion The recognition of patients complicated with low T3 syndrome and acute anterior myocardial infarction plays an important role in predicting the disease severity and long-term outcomes.