促甲状腺激素和总胆红素对冠心病患者经皮冠状动脉介入治疗的预后价值

摘要

Objective :To explore predictive value of thyrotropic—stimulating hormone (TSH) and total bilirubin (TBIL) for prognosis in patients with coronary heart disease (CHD) after percutaneous coronary intervention (PCI).Methods :Accord—ing to serum TBIL and TSH levels ,a total of 156 CHD patients undergoing PCI in our hospital from Feb 2015 to Apr 2017 were divided into high TSH group (n＝72) ,low TSH group (n＝84) and high TBIL group (n＝94) ,low TBIL group (n＝62).Clinical indexes ,coronary disease feature and PCI condition were compared between different TSH and TBIL level groups.The survival condition in followed up within one year were compared between different TBIL and TSH level group . Results :Compared with low TSH group ,there were significant rise in percentages of hypertension and smokers ,Hb and SUA levels ,LVEDd and LVEF ,and significant reductions in levels of FBG and hsCRP in high TSH group ,P＝0.001 all. Compared with low TBIL group ,there were significant reductions in percentages of hyperlipidemia and DM ,Hb level , LVEDd and LVEF ,and significant rise in hsCRP level in high TBIL group , P＜0.01 all.Compared with low TSH group , there were significant rise in number of implanted stents and stent length in high TSH group , P＜0.01 both ;compared with low TBIL group ,there were significant reductions in percentage of opening lesion ,number of implanted stents and stent length in high TBIL group , P＜0.05 or ＜0.01. Incidence rates of MACE in high TSH group and low TBIL group were significantly higher than those of low TSH group and high TBIL group respectively (19.44% vs.4.76%,25.81% vs. 4.26%) , P＜0.01 both .Kaplan—Meier survival analysis indicated that no—MACE survival rate of high TSH group was sig—nificantly lower than that of low TSH group (83.33% vs.95.24%, P＝0.029) ,and that of low TBIL group was signifi—cantly lower than that of high TBIL group (74.19% vs.95.74%, P＝0.001).Conclusion :Serum levels of TSH and TBIL before PCI are related to prognosis in CHD patients undergoing PCI .Those with high TSH and low TBIL levels before PCI possess poorer prognosis .%目的:探讨促甲状腺激素(TSH)和总胆红素(TBIL)对冠心病(CHD)患者经皮冠状动脉介入治疗(PCI)预后的预测价值.方法:根据测定的血清TBIL和TSH水平,2015年2月～2017年4月在我院进行PCI治疗的156例CHD患者被分为高TSH组(72例) 、低TSH组(84例)以及高TBIL组(94例) 、低TBIL组(62例) .对比治疗前不同水平TSH 、TBIL组患者临床指标、冠脉病变特征以及PCI治疗情况;治疗后 1年不同TBIL 、TSH水平组患者生存情况.结果:与低TSH组比较,高TSH组的高血压及吸烟比例、Hb 、LVEDd 、LVEF 、血尿酸水平显著升高,而空腹血糖及 hsCRP水平显著降低,P均＝0.001 .与低TBIL组比较,高TBIL组的高血脂及糖尿病比例明显减少,Hb水平、LVEDd 、LVEF均显著降低,仅hsCRP水平显著升高,P均＜0.01 .与低TSH组比较,高TSH组置入支架数量和支架长度均显著升高,P均＜0.01 ;与低TBIL组比较,高TBIL组开口病变比例、置入支架数量和支架长度均显著降低(P＜0.05或＜0.01) .高TSH组、低TBIL组患者MACE发生率分别显著高于低 TSH组、高TBIL组(19.44% 比4.76%,25.81% 比4.26%) ,P均＜0.01 . Kaplan—Meier生存分析显示,高TSH组无MACE生存率显著低于低TSH组(83.33% 比95.24%,P＝0.029) ,低TBIL组的无MACE生存率显著低于高 TBIL组(74.19% 比95.74%,P＝0.001) .结论:冠心病 PCI患者术前血清TSH 、TBIL水平与患者预后有关,且术前高水平TSH 、低水平TBIL患者预后较差.