摘要
目的探讨危险分层在急性冠状动脉综合征(ACS)合并甲状腺功能亢进(甲亢)介入时机中的运用。方法选取2020年1月至2023年5月在我院诊断为ACS及甲亢的80例患者为观察对象,依据美国心脏病学会和美国心脏病协会(ACC/AHA)关于不稳定型心绞定/非ST段抬高型心肌梗死危险分层和甲亢危象评分法分组,分为ACS高危及极高危、甲亢危象中低危患者32例(A组),甲亢危象高危且ACS中低危患者30例(B组),甲亢危象、ACS中低危患者18例(C组)。比较两组不同介入治疗时机下不同时间点心血管事件、甲亢危象或甲亢加重的发生情况。结果A组、B组、C组住院期间心血管事件发生率无统计学意义(P>0.05);A组、B组、C组出院1个月时心血管事件、甲亢危象或甲亢加重发生率无统计学意义(P>0.05);A组、B组、C组出院1年时心血管事件、甲亢危象或加重发生率无统计学意义(P>0.05)。结论危险分层在ACS合并甲状腺功能亢进介入时机中发挥积极作用,对ACS高危及极高危患者进行积极的介入治疗,不明显增加甲亢危象的发生和/或甲亢的加重,而对ACS中低危而甲亢危象高危者进行药物保守治疗即甲亢控制后再行介入治疗,并不增加发生心血管事件的风险。
Objective To explore the application of risk stratification in the timing of intervention for acute coronary syndrome(ACS)combined with hyperthyroidism.Methods A total of 80 patients diagnosed with ACS and hyperthyroidism in our hospital from January 2020 to May 2023 were selected as the observation targets.According to the risk stratification and hyperthyroidism crisis scoring method of unstable heart attack/non ST segment elevation myocardial infarction by the American College of Cardiology/American Heart Association(ACC/AHA),they were divided into 32 patients with ACS high-risk and extremely high-risk,low risk of hyperthyroidism crisis(Group A),30 patients with hyperthyroidism crisis high-risk and ACS low-risk(Group B),and 18 patients with hyperthyroidism crisis and ACS low-risk(Group C).The incidence of cardiovascular events,hyperthyroidism crisis or hyperthyroidism aggravation at different times of interventional treatment was compared between the two groups.Results There was no statistically significant difference in the incidence of cardiovascular events during hospitalization among Group A,Group B,and Group C(P>0.05).There was no statistically significant difference in the incidence of cardiovascular events,hyperthyroidism crisis,or hyperthyroidism exacerbation at one month after discharge among Group A,Group B,and Group C(P>0.05).There was no statistically significant difference in the incidence of cardiovascular events,hyperthyroidism crisis,or exacerbation one year after discharge among Group A,Group B,and Group C(P>0.05).Conclusions Risk stratification plays a positive role in the timing of intervention for ACS combined with hyperthyroidism.Active intervention treatment for ACS high-risk and extremely high-risk patients does not significantly increase the occurrence and/or aggravation of hyperthyroidism crisis.However,conservative drug treatment for ACS low-risk and hyperthyroidism crisis high-risk patients,that is,intervention treatment after controlling hyperthyroidism,does not increase the risk of
作者
范小明
廖晓东
易闽超
FAN Xiaoming;Liao Xiaodong;YI Minchao(Department of Cardiovascular Medicine,First People’s Hospital of Nankang District,Ganzhou City,Ganzhou 341001,China;Department of Respiratory Medicine,the First People’s Hospital of Nankang District,Ganzhou City,Ganzhou 341400,China)
出处
《中国医药指南》
2024年第36期75-78,共4页
Guide of China Medicine
基金
危险分层在ACS合并甲状腺功能亢进介入时机中的临床研究(GZ2023ZSF498)。
关键词
急性冠状动脉综合征
甲状腺功能亢进
危险分层
介入时机
Acute coronary syndrome
Hyperthyroidism
Dangerous stratification
Opportunity for intervention
