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低T3综合征对冠心病患者PCI后预后的影响

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目的 分析游离三碘甲状腺原氨酸(FT3)降低对冠状动脉粥样硬化性心脏病(冠心病)
患者经皮冠状动脉介入治疗(PCI)后预后的影响。方法 连续纳入2015年1月至2016年1月行PCI的冠心
病患者729例,依据甲状腺功能结果分为甲状腺功能正常组(甲功常组,n=582)和低T3综合征组(低
T3组,n=147)。记录患者的冠状动脉(冠脉)造影结果,并对患者进行随访,随访时间为1年,随访及
比较两组患者主要的心脑血管不良事件发生率。结果 临床资料发现,低T3组的左主干病变发生率更高
(11.21% vs. 1.91%,P<0.001),三支病变发生率也高于甲功正常组(44.83% vs. 34.29%,P=0.042)。随
访结果发现,低T3综合征组的非靶血管血运重建率明显高于甲功正常组(11.21% vs. 1.34%,P<0.001),
多因素COX 回归分析显示性别、PCI史、FT3减低是患者PCI后行非靶血管血运重建的重要影响因素(P
<0.05)。而在心源性死亡、非致命性心肌梗死、脑血管事件,再次靶血管血运重建,两组差异均无统计
学意义(P>0.05)。结论 FT3减低可能是冠心病患者PCI后再次入院行非靶血管血运重建的危险因素。

Abstract:

Objective To analyze the effect of free triiodothyronine (FT3) on the prognosis of patients with
coronary heart disease after percutaneous coronary intervention (PCI). Methods 729 consecutive patients with
coronary heart disease who underwent PCI from January 2015 to January 2016 were randomly divided into normal
thyroid function group (582 cases) and low T3 syndrome group (147 cases). The patient's coronary angiography
results were recorded and the patients were followed up for 1 year. The incidence of major cardiovascular and
cerebrovascular adverse events was compared between the two groups. Results Clinical data showed that the
incidence of left main lesions was higher in the low T3 group (11.21% vs. 1.91%, P<0.001), and the incidence of
three-vessel disease was also higher than that in the normal group (44.83% vs. 34.29%, P=0.042). The follow-up
results showed that the rate of non-target vessel revascularization in the low T3 syndrome group was significantly
higher than that in the normal group (11.21% vs. 1.34%, P<0.001). Multivariate COX regression analysis showed
gender, PCI history, and FT3 reduction. It was an important factor in the non-target vessel revascularization after
PCI (P<0.05). There were no significant differences between the two groups in cardiac death, non-fatal myocardial
infarction, cerebrovascular events, and revascularization of target vessels (P>0.05). Conclusion The decrease of
FT3 may be a risk factor for revascularization of non-target vessels in patients with coronary heart disease after PCI.

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