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目的观察急性冠状动脉综合征(ACS)患者住院期间甲状腺激素(TH)、心肌肌钙蛋白Ⅰ(cTnI)和B型钠尿肽(BNP)水平的变化,探讨其与主要不良心脏事件(MACE)发生的关系。方法随机选取ACS患者120例,按照病型分为ST段抬高型心肌梗死(STEMI)、非ST段抬高型心肌梗死(NSTEMI)和不稳定性心绞痛(UA)3个亚组;按照患者住院期间是否再次发生MACE分为发生组[MACE(+)]和未发生组[MACE(-)],分别观察TH、cTnI和BNP水平。结果 NSTEMI组和STEMI组总三碘甲状腺原氨酸(TT3)水平明显低于UA组(P<0.05、P<0.01);NSTEMI组游离三碘甲状腺原氨酸(FT3)水平明显低于STEMI组和UA组(P<0.05)。MACE(+)组TT3和FT3水平明显低于MACE(-)组(P<0.01)。STEMI组、NSTEMI组cTnI水平明显高于UA组(P<0.01),NSTEMI组高于STEMI组(P<0.05),但在MACE(+)和MACE(-)组之间差异无统计学意义(P>0.05)。促甲状腺激素(TSH)、总甲状腺素(TT4)、游离甲状腺素(FT4)和BNP水平在STEMI、NSTEMI和UA 3组间以及MACE(+)和MACE(-)组间差异均无统计学意义(P>0.05)。MACE(+)组cTnI、BNP阳性率与MACE(-)组比较差异无统计学意义(P>0.05)。结论 ACS患者住院期间出现低TT3和FT3水平易发生MACE;cTnI和BNP对ACS患者住院期间发生MACE无提示意义,有待于进一步研究和探讨。
Objective To observe the changes of thyroid hormone (TH), cardiac troponin Ⅰ (cTnI) and B-type natriuretic peptide (BNP) in patients with acute coronary syndrome (ACS) during hospitalization and to explore the relationship between them and major adverse cardiac events (MACE) What happened? Methods A total of 120 ACS patients were randomly divided into three groups: STEMI, NSTEMI and UA. According to the patients MACE was divided into occurrence group [MACE (+)] and absence group [MACE (-)] during hospitalization, and TH, cTnI and BNP levels were observed. Results The levels of total triiodothyronine (TT3) in NSTEMI group and STEMI group were significantly lower than those in UA group (P <0.05, P <0.01). The levels of free triiodothyronine (FT3) in NSTEMI group were significantly lower than those in STEMI group And UA group (P <0.05). The levels of TT3 and FT3 in MACE (+) group were significantly lower than those in MACE (-) group (P <0.01). The levels of cTnI in STEMI group and NSTEMI group were significantly higher than those in UA group (P <0.01), NSTEMI group was higher than STEMI group (P <0.05), but there was no significant difference between MACE (+) and MACE (- P> 0.05). The levels of TSH, TT4, FT4 and BNP in STEMI, NSTEMI and UA 3 groups and between MACE (+) and MACE (-) groups were not significantly different (P> 0.05). There was no significant difference in the positive rates of cTnI and BNP between MACE (+) group and MACE (-) group (P> 0.05). Conclusions The low TT3 and FT3 levels are prone to MACE during hospitalization in patients with ACS. CTnI and BNP are of no significance to MACE during hospitalization of ACS patients, which needs further study and discussion.