摘要： 目的 探讨急性缺血性卒中患者血清甲状腺激素水平变化与病情严重程度和短期预后的相关性。方法 根据血清总三碘甲状腺原氨酸（TT3）水平将98 例既往无甲状腺疾病史的急性缺血性卒中患者分为低TT3 组和正常TT3 组，检测血清甲状腺激素水平和神经功能缺损程度，评价发病90 d 时神经功能恢复情况。结果 低TT3 组患者神经功能缺损程度比正常TT3 组严重（χ2 = 58.134，P = 0.000），血清总甲状腺素（t = 1.636，P = 0.105）和促甲状腺激素（t = 1.059，P = 0.292）水平基本相同；血清TT3 水平与神经功能缺损程度［美国国立卫生研究院卒中量表（NIHSS）］呈负相关关系（r = -0.672，P = 0.000）；发病90 d 时低TT3 组患者神经功能改善程度［NIHSS 评分改善（χ2 = 8.993，P = 0.003）和改良Rankin 量表评分（χ2 = 6.247，P = 0.012）］低于正常TT3 组。结论 血清低T3 水平与急性缺血性卒中严重程度和神经功能改善程度存在关联性，提示血清低T3水平可能是预测急性缺血性卒中神经功能预后的一项指标。
关键词:
脑缺血,
甲状腺激素类,
功能正常甲状腺病综合征
Abstract: Objective To explore the correlation between thyroid hormone levels in patients with acute ischemic stroke and the severity of disease and short-term prognosis. Methods According to the level of serum total triiodothyronine (TT3), 98 patients who presented first acute ischemic stroke and without history of thyroid abnormality were divided into low TT3 group and normal TT3 group. Thyroid hormone levels and neurological function defect of those patients were tested, and their neural functional recovery after 3 months was evaluated. Results Low TT3 group had more severe neural function defect compared to normal TT3 group (χ2 = 58.134, P = 0.000). There were no significant differences on total thyroxine (TT4; t = 1.636, P = 0.105) and thyroid stimulating hormone (TSH; t = 1.059, P = 0.292) between 2 groups. There was a significantly negative correlation between TT3 levels and National Insititute of Health Stroke Scale (NIHSS) score on admission (r = -0.672, P = 0.000). Patients with low TT3 showed a significantly smaller percentage of neurological function improvement on both NIHSS ( χ2 = 8.993, P = 0.003) and modified Rankin Scale (mRS; χ2 = 6.247, P = 0.012) scores compared to those with normal TT3 at 90 d after onset. Conclusions Low T3 level is associated with the severity of acute ischemic stroke and neural functional recovery, suggesting serum T3 level may be a predictor of neural function improvement in patients with acute ischemic stroke.
Key words:
Brain ischemia,
Thyroid hormones,
Euthyroid sick syndromes
陈国栋, 肖瑾, 刘兵荣, 王峰. 急性缺血性卒中患者血清甲状腺激素表达变化对神经功能预后的预测价值[J]. 中国现代神经疾病杂志, 2015, 15(2): 133-136.
CHEN Guo-dong, XIAO Jin, LIU Bing-rong, WANG Feng. The predictive value of thyroid hormone levels on the neurological outcomes of patients with acute ischemic stroke[J]. Chinese Journal of Contemporary Neurology and Neurosurgery, 2015, 15(2): 133-136.