促甲状腺激素对冠心病患者行经皮冠状动脉介入术预后的影响

张玉琳; 宋耀明

doi:10.16016/j.1000-5404.201610060

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促甲状腺激素对冠心病患者行经皮冠状动脉介入术预后的影响

更新时间：2026-01-09

- 促甲状腺激素对冠心病患者行经皮冠状动脉介入术预后的影响
- Influence of thyroid-stimulating hormone within reference range on patients with coronary heart disease after percutaneous coronary intervention
- 第三军医大学学报 2017年39卷第6期页码：568-573
- 作者机构：
  
  400037 重庆，第三军医大学新桥医院心血管内科，全军心血管病研究所
- 作者简介：
  
  [宋耀明,E-mail:sym551342002@126.com Song Yaoming, E-mail:sym551342002@126.com
- 基金信息：
- DOI：10.16016/j.1000-5404.201610060
  中图分类号： R181.32; R446.112; R541.405
- 收稿：2016-10-11，
  
  修回：2016-12-03，
  
  纸质出版：2017-06
- 稿件说明：
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张玉琳, 宋耀明. 促甲状腺激素对冠心病患者行经皮冠状动脉介入术预后的影响[J]. 第三军医大学学报, 2017,39(6):568-573.

Yulin Zhang, Yaoming Song. Influence of thyroid-stimulating hormone within reference range on patients with coronary heart disease after percutaneous coronary intervention[J]. Journal of Third Military Medical University, 2017, 39(6): 568-573.
张玉琳, 宋耀明. 促甲状腺激素对冠心病患者行经皮冠状动脉介入术预后的影响[J]. 第三军医大学学报, 2017,39(6):568-573. DOI： 10.16016/j.1000-5404.201610060.

Yulin Zhang, Yaoming Song. Influence of thyroid-stimulating hormone within reference range on patients with coronary heart disease after percutaneous coronary intervention[J]. Journal of Third Military Medical University, 2017, 39(6): 568-573. DOI： 10.16016/j.1000-5404.201610060.

摘要

目的

研究正常范围内不同浓度梯度的促甲状腺激素 (thyroid-stimulating hormone，TSH) 对冠心病患者行经皮冠状动脉介入术 (percutaneous coronary interventions，PCI) 预后的影响及其临床意义。

方法

回顾性纳入1 002例行PCI且TSH处于正常范围内 (0.30~4.20 μIU/mL) 的冠心病患者，将受试者分为3组：TSH正常低值组 (0.30~1.60 μIU/mL

387例)、TSH正常中值组 (1.61~2.90 μIU/mL，413例)、TSH正常高值组 (2.91~4.20 μIU/mL，202例)，随访时间1年，终点事件是全因死亡，并统计出血事件和再入院事件。

结果

正常低值组全因死亡事件6例，全因死亡率1.55%；正常中值组全因死亡事件8例，全因死亡率1.94%；正常高值组全因死亡事件10例，全因死亡率4.95%；各组之间比较差异有统计学意义 (

0.05)。正常低值组再出血事件13例，再出血率3.36%；正常中值组再出血事件14例，再出血率3.39%；正常高值组再出血事件16例，再出血率7.92%；各组之间比较差异有统计学意义 (

0.05)。正常低值组再入院事件38例，再入院率9.82%；正常中值组再入院事件27例，再入院率6.54%；正常高值组再入院事件15例，再入院率7.43%；各组之间比较差异无统计学意义 (

0.05)。Logistic回归分析显示正常高值的TSH (

=1.48) 是PCI术后全因死亡的危险因素，同时正常高值的TSH (

=1.47) 是PCI术后出血的危险因素。生存分析也进一步证明正常高值的TSH是PCI术后全因死亡的危险因素 (

0.05)。

结论

TSH水平越高，全因死亡事件、再出血事件的发生率越高；正常高值的TSH是经皮冠状动脉介入治疗的全因死亡和出血事件的危险因素。

Abstract

Objective

To observe the prognosis value of thyroid-stimulating hormone (TSH) within reference range in patients with coronary heart disease (CHD) after percutaneous coronary intervention (PCI) and its clinical significance.

Methods

One thousand and two patients with CHD

who received PCI and had TSH in the normal range (0.3~4.2 μIU/mL)

were enrolled. The patients were divided into 3 groups: Low-normal TSH group (0.30~1.60 μIU/ml

=387)

the middle-normal TSH group (1.61~2.90 μIU/mL

=413)

and the high-normal TSH group (2.91~4.20 μIU/mL

=202). All of them were followed up for 1 year

and primary end point was all-cause mortality. Peri-PCI bleeding and readmission were also recorded.

Results

The low-normal group experienced an all-cause mortality rate of 1.55%

a peri-PCI bleeding rate of 3.36%

and a readmission rate of 9.82%. The middle-normal group had an all-cause mortality rate of 1.94%

a peri-PCI bleeding rate of 3.39%

and a readmission rate of 6.54%. The high-normal group experienced an all-cause mortality rate of 4.95%

a peri-PCI bleeding ra

te of 7.92%

and a readmission rate of 7.43%. There were significant differences in one-year all-cause mortality and peri-PCI bleeding among the 3 groups (all

0.05)

and there was no significant difference in the readmission among them (

0.05). Logistic regression analysis showed that TSH in the upper reference range was a risk factor in one-year all-cause mortality (

=1.48

0.05) and peri-PCI bleeding (

=1.47

0.05). Survival analysis also showed that TSH in the upper reference Limit was a risk factor in one-year all-cause mortality (

=1.566

0.05).

Conclusion

TSH in the upper reference Limit is an independence risk factor in one-year all-cause mortality and peri-PCI bleeding in the patients with CHD after PCI.

关键词

Keywords

references

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